Individual
ANN L MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4110 BRIARGATE PKWY, SUITE 465, COLORADO SPRINGS, CO 80920-7835
(719) 365-6568
(719) 364-3582
Mailing address
4110 BRIARGATE PKWY, SUITE 465, COLORADO SPRINGS, CO 80920-7835
(719) 365-6568
(719) 364-3582
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
036096502
IL
207RH0003X
Hematology & Oncology Physician
Primary
DR.0056052
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096502
—
IL
Enumeration date
01/17/2006
Last updated
12/08/2015
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