Individual
DR. MELODIE M ICASIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER, BLDG 9040 FITZSIMMONS DR., TACOMA, WA 98431-0001
(253) 968-1740
Mailing address
100 LANCASTER AVE, MOB EAST SUITE 158, WYNNEWOOD, PA 19096-3427
(610) 649-2126
(610) 642-7814
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00042886
WA
Other
Enumeration date
02/28/2006
Last updated
04/22/2016
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