Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD-44669 | IA |
N | 2080P0208X | Pediatric Infectious Diseases | 210409 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | MD-44669 | IA |
NPI | 1619908191 |
---|---|
Provider Name | Dr. Melanie A Wellington |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01975502 | (05) | NY |
H81883 | (02) |