Provider Demographics
NPI:1972688554
Name:MELLMAN, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:MELLMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:# 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-320-2929
Mailing Address - Fax:303-320-2767
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:303-320-2929
Practice Address - Fax:303-320-2767
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO36116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60827211Medicaid
CO01361161Medicaid
CO60827211Medicaid
COP00996389Medicare PIN
COC495158Medicare PIN
COC224028Medicare PIN