Individual
WALTER MELNYCZENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2603 W RAWSON AVE, OAK CREEK, WI 53154-8422
(414) 764-1330
Mailing address
2448 S 102ND ST, STE 125, WEST ALLIS, WI 53227-2466
(414) 328-3813
(414) 328-3818
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28732
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30817100
—
WI
Enumeration date
07/17/2006
Last updated
07/08/2007
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