Provider Demographics
NPI:1043257348
Name:ALLAN, MELISSA Y (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:Y
Last Name:ALLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 N HIGH POINT RD
Mailing Address - Street 2:DEAN MEDICAL CENTER
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2236
Mailing Address - Country:US
Mailing Address - Phone:608-824-4800
Mailing Address - Fax:608-824-4910
Practice Address - Street 1:752 N HIGH POINT RD
Practice Address - Street 2:DEAN MEDICAL CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2236
Practice Address - Country:US
Practice Address - Phone:608-824-4800
Practice Address - Fax:608-824-4910
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI45902-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1043257348Medicaid
WI60241OtherDEAN HEALTH INSURANCE
WI34458500Medicaid
WI60241OtherDEAN HEALTH INSURANCE
WI086374150Medicare PIN