Provider Demographics
NPI:1013177526
Name:MARZOLF, MELINDA KAY (DO)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:KAY
Last Name:MARZOLF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16307 6900 RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-7461
Mailing Address - Country:US
Mailing Address - Phone:970-514-5463
Mailing Address - Fax:970-645-3167
Practice Address - Street 1:336 S 10TH ST STE 107
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4934
Practice Address - Country:US
Practice Address - Phone:970-514-5463
Practice Address - Fax:970-645-3167
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79352073Medicaid
CO022994OtherKAISER COMMERCIAL NUMBER
CO022994OtherKAISER COMMERCIAL NUMBER