Provider Demographics
NPI:1164570701
Name:BATMAN, MELINDA BERNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:BERNA
Last Name:BATMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:BERNA
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:544 COLECROFT CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2174
Mailing Address - Country:US
Mailing Address - Phone:703-717-9086
Mailing Address - Fax:240-857-6263
Practice Address - Street 1:1058 W. PERIMETER ROAD
Practice Address - Street 2:MGMC - PEDIATRIC CLINIC
Practice Address - City:ANDREWS AFB
Practice Address - State:MD
Practice Address - Zip Code:20762-6602
Practice Address - Country:US
Practice Address - Phone:240-857-2723
Practice Address - Fax:240-857-6263
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31381208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics