Individual
MELPOMENI G KAVADELLA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6051 FRANKFORT HWY, SUITE #200, BENZONIA, MI 49616-9558
(231) 882-2168
Mailing address
9310 EVERGREEN DR, TRAVERSE CITY, MI 49684-7822
(231) 935-0355
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4208349
—
MI
01
—
4301407649
STATE LICENSE NUMBER
MI
01
—
MK407649
3RD PARTY IDENTIFIER
MI
Enumeration date
02/15/2006
Last updated
03/07/2023
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