Wallace, Melanie
Wallace, Melanie is an individual health care provider with primary practice located at 845 S Madison St , Tupelo MS 38801-4905. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wallace, Melanie can be contacted via phone (662) 377-5930.Contact Information
Primary practice address
845 S Madison St
Tupelo MS 38801-4905
Phone: (662) 377-5930
Fax: (662) 377-5085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 11799 | Mississippi |
Profile Details
| NPI number | 1346207222 |
|---|---|
| LBN Legal business name | Wallace, Melanie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Jul 14th, 2010 - about 15 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 | 1346207222 | NPPES |
| Mississippi | MEDICAID | 00114470 |
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