Individual
MELODIE ISGRO
Active
Individual
MELODIE ISGRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
109713
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930110029
RR MEDICARE
OR
Enumeration date
06/25/2006
Last updated
06/18/2024
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