Individual
MELDA S. DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3635 VISTA AVE, 14TH FLOOR, SAINT LOUIS, MO 63110-2539
(314) 577-8890
(314) 268-5172
Mailing address
3691 RUTGER ST, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110-2515
(314) 977-6828
(314) 977-6777
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1999143039
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205094303
—
MO
Enumeration date
09/25/2006
Last updated
07/08/2007
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