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Individual

MICHELLE L. MELLION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2 DUDLEY ST, SUITE 555, PROVIDENCE, RI 02905-3236
(401) 444-3032
(401) 444-3205
Mailing address
2 DUDLEY ST, SUITE 555, PROVIDENCE, RI 02905-3236
(401) 444-3032
(401) 444-3205

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD12012
RI
2084N0600X
Clinical Neurophysiology Physician
MD12012
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD12012
MEDICAL LICENSE
RI
Enumeration date
06/06/2006
Last updated
02/25/2015
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