Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 30215 | AL |
NPI | 1134386964 |
---|---|
Provider Name | Melanie Rose |
First Address | Mobile, AL 36607-2301 |
Second Address | Mobile, AL 36607-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 03/03/2016 |