Provider Demographics
NPI:1295034767
Name:KREINER, MELANIE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE
Last Name:KREINER
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 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-4411
Mailing Address - Fax:
Practice Address - Street 1:2406 BLUE RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6678
Practice Address - Country:US
Practice Address - Phone:919-786-5001
Practice Address - Fax:919-786-5051
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00940208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC201400940OtherLICENSE NUMBER