Individual
DR. FERNANDO MELKUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1010
(217) 544-6464
(177) 576-5372
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1010
(217) 544-6464
(177) 576-5372
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036146948
IL
207L00000X
Anesthesiology Physician
2006017903
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101740083
—
MO
05
—
1104027697
—
MN
05
—
7100200820
—
KY
Enumeration date
05/30/2007
Last updated
08/12/2022
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