Individual
MELANIE K JOHANNESSOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W 10TH ST, INDIANAPOLIS, IN 46202-2859
(317) 630-7979
(317) 630-2668
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01045603A
IA
208000000X
Pediatrics Physician
Primary
01045603A
IN
208M00000X
Hospitalist Physician
01045603A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200002280
—
IN
Enumeration date
05/02/2006
Last updated
09/22/2025
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