Provider Demographics
NPI:1659414712
Name:MELE, CHRISTOPHER DEAN (MT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DEAN
Last Name:MELE
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1181
Mailing Address - Street 2:56 JACOBSON PL. #1
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-1181
Mailing Address - Country:US
Mailing Address - Phone:719-486-1894
Mailing Address - Fax:
Practice Address - Street 1:56 JACOBSON PL UNIT 1
Practice Address - Street 2:56 JACOBSON PL. #1
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3376
Practice Address - Country:US
Practice Address - Phone:719-486-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
160722246QM0706X
059595246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
Not Answered246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO059595OtherMLT-ASCP NATIONAL CERT
CO160722OtherMT-AMT IS A NATIONAL CERT