Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125:061758 | IL |
N | 111NI0900X | Internist | 125:061758 | IL |
N | 207R00000X | Internist | MD-44688 | IA |
N | 111NI0900X | Internist | MD-44688 | IA |
Y | 207RA0201X | Internist - Allergy & Immunology | MD-44688 | IA |
NPI | 1588927867 |
---|---|
Provider Name | Dr. Shayna Ravindran Melvani |
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 | 21/06/2012 |
Last Update Date | 17/03/2018 |