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Individual
CARRIE A MELLOH
Active
Individual
CARRIE A MELLOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060755A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000602397
ANTHEM
IN
01
—
000000659135
ANTHEM
IN
05
—
200521880
—
IN
Enumeration date
07/11/2006
Last updated
11/27/2023
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