Provider Demographics
NPI:1407896566
Name:LIPTON, MELISSA CANHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:CANHAM
Last Name:LIPTON
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 1:1746 COLE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3208
Mailing Address - Country:US
Mailing Address - Phone:303-914-8800
Mailing Address - Fax:303-716-3777
Practice Address - Street 1:1746 COLE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3208
Practice Address - Country:US
Practice Address - Phone:303-914-8800
Practice Address - Fax:303-716-3777
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-008772085R0202X
CO523052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC9015OtherMEDCOST
NC131N5OtherBLUECROSS BLUESHIELD
NC16-01405OtherUNITED HEALTHCARE
NCC8230OtherMEDCOST
NC16-01806OtherUNITED HEALTHCARE
NC16-01807OtherUNITED HEALTHCARE
NCC9016OtherMEDCOST
NC3426230OtherAETNA
NCP00164740OtherRAILROAD MEDICARE
NC891215NMedicaid
NCP00108518OtherRAILROAD MEDICARE
NCC8230OtherMEDCOST
H60373Medicare UPIN
CO301875YLQ8Medicare PIN
CO301875YVYGMedicare PIN
NC131N5OtherBLUECROSS BLUESHIELD
NC2001487AMedicare ID - Type Unspecified