Individual
DEEPA MELANIE ETIKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
306 WESTWOOD AVE STE 501, HIGH POINT, NC 27262-4342
(256) 698-7888
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2022-02495
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2018
Last updated
11/15/2022
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