Individual
MELANIE ANN MAILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5433 W FOND DU LAC AVE, MILWAUKEE, WI 53216-1382
(414) 277-8900
(414) 277-8939
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101231620
VA
208000000X
Pediatrics Physician
Primary
53698-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010217504
—
VA
05
—
1780647263
—
WI
05
—
5903026
—
NC
Enumeration date
04/07/2006
Last updated
07/15/2016
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