Individual
MELISSA BEARDEN VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1855 SPRINGHILL AVE, MOBILE, AL 36607-2301
(251) 471-3544
(251) 476-7254
Mailing address
1855 SPRINGHILL AVE, MOBILE, AL 36607-2301
(251) 471-3544
(251) 476-7254
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-63
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-42399
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/14/2005
Last updated
12/07/2009
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