Provider Demographics
NPI:1043378623
Name:MACLIN, VICTORIA MELANIE (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MELANIE
Last Name:MACLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 S 142ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6804
Mailing Address - Country:US
Mailing Address - Phone:402-717-4200
Mailing Address - Fax:402-717-4231
Practice Address - Street 1:7308 S 142ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138-6804
Practice Address - Country:US
Practice Address - Phone:402-717-4200
Practice Address - Fax:402-717-4231
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19897207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEC46098Medicare UPIN