Provider Demographics
NPI:1700107075
Name:ROTTA, MARCELLO M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELLO
Middle Name:M
Last Name:ROTTA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:DENVER
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:720-754-4800
Mailing Address - Fax:720-754-4801
Practice Address - Street 1:1721 E 19TH AVE STE 300
Practice Address - Street 2:DENVER
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1258
Practice Address - Country:US
Practice Address - Phone:720-754-4800
Practice Address - Fax:720-754-4801
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2023-07-26
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Provider Licenses
StateLicense IDTaxonomies
CO56866207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO527937YWUPMedicare PIN