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Individual

DR. MICHAEL GERARDO MELENDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2789 E SPYGLASS CT, COEUR D ALENE, ID 83815
(208) 610-0041
(208) 777-1313
Mailing address
2789 E SPYGLASS CT, COEUR D ALENE, ID 83815
(208) 762-0288
(208) 777-1313

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
160913-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
M-3755
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8111379
WA
Enumeration date
11/17/2006
Last updated
07/08/2007
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