Provider Demographics
NPI:1558350785
Name:MEALER, DAREN ROGER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAREN
Middle Name:ROGER
Last Name:MEALER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:799 MESA CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-7433
Mailing Address - Country:US
Mailing Address - Phone:719-232-4328
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:DEPT. OF FAMILY MEDICINE
Practice Address - City:U S A F ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-2502
Practice Address - Country:US
Practice Address - Phone:719-333-2273
Practice Address - Fax:719-333-0505
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COVAD000Medicare UPIN