Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4301114086 | MI |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD.202419 | LA |
NPI | 1023216777 |
---|---|
Provider Name | Dr. Melanie Andene Edwards |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2007 |
Last Update Date | 03/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08300274 | (05) | MS |
1199923 | (05) | LA |