Provider Demographics
NPI:1619022738
Name:O'MELIA, ANNE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:O'MELIA
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 1:7351 E LOWRY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6083
Mailing Address - Country:US
Mailing Address - Phone:720-214-4623
Mailing Address - Fax:
Practice Address - Street 1:8199 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7163
Practice Address - Country:US
Practice Address - Phone:720-370-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT346254-12052084P0804X
OH35091989208000000X
WAMD610262842084P0804X
IL0361469732084P0804X
MDD00885832084P0804X
COCDRH00543422084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036146973OtherSTATE MEDICAL LICENSE
UT3462541205OtherSTATE MEDICAL LICENSE
MDD0088583OtherSTATE MEDICAL LICENSE
WAMD61026284OtherSTATE MEDICAL LICENSE
COCDRH.0054342OtherSTATE LICENSE
OH35091989OtherSTATE MEDICAL LICENSE