Individual
DR. KENT E MELLERSTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1043 SLATE DR, SANTA ROSA, CA 95405-8841
(707) 527-7211
(707) 538-7044
Mailing address
1043 SLATE DR, SANTA ROSA, CA 95405-8841
(707) 527-7211
(707) 538-7044
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G18760
CA
Other
Enumeration date
11/23/2005
Last updated
10/04/2011
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