Provider Demographics
NPI:1164623393
Name:COAKER, MELISA (MD)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:COAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1275 NW 128TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325
Mailing Address - Country:US
Mailing Address - Phone:515-224-3948
Mailing Address - Fax:515-224-2944
Practice Address - Street 1:1275 NW 128TH ST
Practice Address - Street 2:STE 200
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325
Practice Address - Country:US
Practice Address - Phone:734-502-6716
Practice Address - Fax:515-358-9650
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA38855207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine