NPI | 1578549010 |
---|---|
Former Name | MELINDA S. SHADOWITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 251720) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35070556) |
207Q00000X Family Medicine (Licence: ME 017423) | |
207R00000X Internal Medicine (Licence: CT 64731) | |
Enumeration Date | 2005-12-16 |
Last Update Date | 2020-01-31 |