Individual
MELISSA HEIDI LUDWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
380 N 200 W, SUITE 209, BOUNTIFUL, UT 84010-7079
(801) 298-1300
(801) 296-6199
Mailing address
380 N 200 W, SUITE 209, BOUNTIFUL, UT 84010-7079
(801) 298-1300
(801) 296-6199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4797308-1206
UT
363AM0700X
Medical Physician Assistant
4797308-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00662902
RR MEDICARE
UT
Enumeration date
11/10/2008
Last updated
03/10/2010
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