Individual
DR. MELANIE NYEH KETCHANDJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1145 SOUTH UTICA AVENUE, SUITE 202, TULSA, OK 74104-4022
(918) 579-3130
(918) 579-3139
Mailing address
1145 S UTICA AVE, STE 202, TULSA, OK 74104-4022
(918) 579-3130
(918) 579-3139
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
31609
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200596260A
—
OK
Enumeration date
09/17/2012
Last updated
08/11/2015
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