Provider Demographics
NPI:1942300751
Name:MELMED, MEIR HERZL (MD)
Entity Type:Individual
Prefix:MR
First Name:MEIR
Middle Name:HERZL
Last Name:MELMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10099 RIDGE GUTE PARKWAY, SUITE 280
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-791-2112
Mailing Address - Fax:303-683-6415
Practice Address - Street 1:10099 RIDGE GUTE PARKWAY, SUITE 280
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-791-2112
Practice Address - Fax:303-683-6415
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21140207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01211408Medicaid
CO348308OtherMEDICARE GROUP NUMBER
CO810212OtherMEDICARE GROUP NUMBER
CO47688343OtherMEDICAID PRACTICE NUMBER
364228OtherMEDICARE
CO76580237OtherMEDICAID GROUP NUMBER
CO348308OtherMEDICARE GROUP NUMBER
CO810272Medicare PIN
CO76580237OtherMEDICAID GROUP NUMBER