Individual
MALLORY MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
715 DR MARTIN LUTHER KING JR AVE NE STE 301, ALBUQUERQUE, NM 87102-3668
(505) 727-7090
(505) 727-9590
Mailing address
3333 S BANNOCK ST, STE 350, ENGLEWOOD, CO 80110-2426
(515) 643-2261
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
60839
CO
208600000X
Surgery Physician
Primary
A-2513-21
NM
208600000X
Surgery Physician
R9727
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000162980
—
CO
Enumeration date
06/28/2013
Last updated
07/12/2021
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