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Individual

MRS. KATIE MARIE MELLENDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5755 CEDAR LN, SUITE 134, COLUMBIA, MD 21044-2912
(410) 740-7777
(410) 884-4749
Mailing address
5755 CEDAR LN, SUITE 134, COLUMBIA, MD 21044-2912
(410) 740-7777
(410) 884-4749

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MD

Other

Enumeration date
09/13/2011
Last updated
10/27/2011
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