Provider Demographics
NPI:1356541049
Name:BISHOP, MELISSA OJEDA (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:OJEDA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:M
Other - Last Name:OJEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 EXEMPLA CIRCLE
Mailing Address - Street 2:SUITE 470
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3396
Mailing Address - Country:US
Mailing Address - Phone:303-665-6016
Mailing Address - Fax:303-665-0121
Practice Address - Street 1:300 EXEMPLA CIRCLE
Practice Address - Street 2:SUITE 470
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3396
Practice Address - Country:US
Practice Address - Phone:303-665-6016
Practice Address - Fax:303-665-0121
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115047207V00000X
CODR.0052556207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036115047OtherSTATE LICENSE
ILK40031Medicare PIN