MEDICARE: DR. KELLY ANN MCALEESE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	34520	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	841360845001	OTHER	CO	PACIFICARE

General Provider Information

NPI Number	:	1982667416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY ANN MCALEESE MD

Provider Business Mailing Address
First Line	:	3773 CHERRY CREEK NORTH DRIVE
Second Line	:	SUITE 101
City	:	DENVER
State	:	CO
Zip	:	80209
Country	:	US
Telephone Number	:	303-321-2273
Fax Number	:	303-321-3641

Provider Business Practice Location Address
First Line	:	3773 CHERRY CREEK NORTH DR
Second Line	:	SUITE 101
City	:	DENVER
State	:	CO
Zip	:	80209-3804
Country	:	US
Telephone Number	:	303-321-2273
Fax Number	:	303-321-3641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	07/08/2007

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