Provider Demographics
NPI:1487798021
Name:GRUEN, MELISSA BETH (MD, JD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:BETH
Last Name:GRUEN
Suffix:
Gender:F
Credentials:MD, JD
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Mailing Address - Street 1:5023 W 120TH AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5606
Mailing Address - Country:US
Mailing Address - Phone:720-644-9355
Mailing Address - Fax:
Practice Address - Street 1:5920 MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-7445
Practice Address - Country:US
Practice Address - Phone:207-434-4876
Practice Address - Fax:303-225-4246
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD430237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46886583Medicaid
CO46886583Medicaid