Individual
DR. MELISSA DIANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5510 S EAST ST STE H, INDIANAPOLIS, IN 46227-1939
(317) 924-8425
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01065758A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200911340
—
IN
01
—
P0084590
RAIL ROAD MEDICARE
IN
Enumeration date
06/11/2008
Last updated
05/31/2022
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