Individual
MRS. NICOLE EDEN MELOGRANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
621 RIDGELY AVE, SUITE 201, ANNAPOLIS, MD 21401
(410) 224-4404
(410) 224-2675
Mailing address
621 RIDGELY AVENUE, SUITE 201, ANNAPOLIS, MD 21401
(410) 224-4404
(410) 224-2675
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C0002638
MA
Other
Enumeration date
05/23/2011
Last updated
05/23/2011
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