Provider Demographics
NPI:1255651188
Name:MERTZ, ANDREA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:MERTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HEALTH PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4644
Mailing Address - Country:US
Mailing Address - Phone:303-666-2720
Mailing Address - Fax:303-666-2734
Practice Address - Street 1:80 HEALTH PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-4644
Practice Address - Country:US
Practice Address - Phone:303-666-2720
Practice Address - Fax:303-666-2734
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0051926208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics