Custer, Melanie
Custer, Melanie is an individual health care provider with primary practice located at 611 Veterans Ave Unit 106 , West Bend WI 53090-2559. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Custer, Melanie can be contacted via phone (262) 353-4460.Contact Information
Primary practice address
611 Veterans Ave Unit 106
West Bend WI 53090-2559
Phone: (262) 353-4460
Fax: (262) 353-4461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 70643-20 | Wisconsin |
Profile Details
| NPI number | 1053686493 |
|---|---|
| LBN Legal business name | Custer, Melanie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2012 |
| Last updated | Feb 9th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053686493 | NPPES |
| Wisconsin | MEDICAID | 1053686493 |
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