Provider Demographics
NPI:1366480816
Name:MELAMED, ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:MELAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1441
Mailing Address - Country:US
Mailing Address - Phone:303-773-9000
Mailing Address - Fax:303-770-1449
Practice Address - Street 1:6801 S YOSEMITE ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1441
Practice Address - Country:US
Practice Address - Phone:303-773-9000
Practice Address - Fax:303-770-1449
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32130174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10025482600OtherNEBRASKA MEDICAID
CO26003329902OtherPACIFICARE
CO1237279OtherUNITED HEALTHCARE
COME38242OtherBLUE CROSS BLUE SHIELD
CO26003329902OtherROCKY MNT HMO
CO01321306Medicaid
COF75086Medicare UPIN
COC807217Medicare PIN