Provider Demographics
NPI:1326328345
Name:MELINI, LOUIS V (PA)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:V
Last Name:MELINI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1140 E 3900 S
Mailing Address - Street 2:360
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1228
Mailing Address - Country:US
Mailing Address - Phone:801-264-8686
Mailing Address - Fax:801-264-8962
Practice Address - Street 1:1140 E 3900 S
Practice Address - Street 2:360
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1228
Practice Address - Country:US
Practice Address - Phone:801-264-8686
Practice Address - Fax:801-264-8962
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT204590-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant