Medellin, Michelle V
Medellin, Michelle V is an individual health care provider with primary practice located at 1100 Wilford Hall Loop, Bldg 4554 Attn: 59 Mdw/Sghc , Jbsa Lackland TX 78236-9908. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Medellin, Michelle V can be contacted via phone (210) 292-6124.Contact Information
Primary practice address
1100 Wilford Hall Loop, Bldg 4554 Attn: 59 Mdw/Sghc
Jbsa Lackland TX 78236-9908
Phone: (210) 292-6124
Fax: (210) 292-7868
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | L0416 | Texas |
Profile Details
| NPI number | 1770571614 |
|---|---|
| LBN Legal business name | Medellin, Michelle V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Dec 13th, 2019 - about 5 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 | 1770571614 | NPPES |
| Texas | MEDICAID | 044912601 |
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