Individual
MELANIE K PRUSAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1906 BELLEVIEW AVE SE, CARILION ROANOKE MEMORIAL HOSPITAL PEDS ED, ROANOKE, VA 24014-1838
(540) 981-8919
Mailing address
1 RIVERSIDE CIR, 4TH FLOOR, ED ADMINISTRATION, ROANOKE, VA 24016-4961
(540) 597-4234
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101243116
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
0101243116
VA
Other
Enumeration date
07/12/2006
Last updated
07/19/2016
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