Individual
DR. MELANIE ANDREA SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9880 ANGIES WAY, SUITE 420, LOUISVILLE, KY 40241-2851
(502) 394-6200
(502) 394-6210
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39555
KY
208000000X
Pediatrics Physician
39555
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000501968
ANTHEM - NMA
—
01
—
082779
SIHO - NMA
—
01
—
2819054000
PAD - NMA
—
01
—
50013988
PASSPORT - NMA
—
05
—
64131170
—
KY
Enumeration date
06/19/2006
Last updated
08/30/2024
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