Dattalo, Melissa Nicole
Dattalo, Melissa Nicole is an individual health care provider with primary practice located at 2880 University Ave , Madison WI 53705-3644. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Dattalo, Melissa Nicole can be contacted via phone (608) 263-7740.Contact Information
Primary practice address
2880 University Ave
Madison WI 53705-3644
Phone: (608) 263-7740
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 60700-20 | Wisconsin |
Profile Details
| NPI number | 1578705067 |
|---|---|
| LBN Legal business name | Dattalo, Melissa Nicole |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2009 |
| Last updated | Jan 20th, 2021 - about 3 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 | 1578705067 | NPPES |
| Maryland | MEDICAID | 055690400 |
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