Individual
MARIAM MELKUMIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3754 W DIVERSEY AVE APT 2, CHICAGO, IL 60647-1160
(630) 386-1754
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 894-5943
(631) 206-9306
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000668
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
06/27/2022
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