Provider Demographics
NPI:1134446461
Name:MARDONES, MABEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MABEL
Middle Name:A
Last Name:MARDONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4758
Mailing Address - Country:US
Mailing Address - Phone:303-930-7895
Mailing Address - Fax:832-601-6018
Practice Address - Street 1:4700 HALE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4051
Practice Address - Country:US
Practice Address - Phone:033-210-3023
Practice Address - Fax:303-321-9296
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP8274207R00000X, 207RH0003X
390200000X
CODR.0060709207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01800849OtherRAILROAD
TX333672901Medicaid
TX333672902Medicaid
CO9000165257Medicaid
TX333672901Medicaid