Individual
DR. AMY SUSAN MAROLDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
175 S. UNION BLVD., SUITE 305, COLORADO SPRINGS, CO 80910-3126
(719) 365-6881
(719) 365-6877
Mailing address
4419 CENTENNIAL BLVD, #244, COLORADO SPRINGS, CO 80907-3739
(719) 963-4170
(719) 548-0338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28328
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01283282
—
CO
01
—
MA28328
BLUE SHIELD
CO
Enumeration date
02/07/2007
Last updated
08/20/2018
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