Provider Demographics
NPI:1487849642
Name:MALEKI FISCHBACH, MEHRNAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHRNAZ
Middle Name:
Last Name:MALEKI FISCHBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEHRNAZ
Other - Middle Name:
Other - Last Name:MALEKI MASOULEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2761
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-398-1211
Practice Address - Street 1:1400 JACKSON STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2761
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:303-270-2206
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49441207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15377873Medicaid
CO49441OtherCOLORADO MEDICAL BOARD
CO49441OtherCOLORADO MEDICAL BOARD