Provider Demographics
NPI:1376521914
Name:CLOONAN SCHULTE, MELANIE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:D
Last Name:CLOONAN SCHULTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:D
Other - Last Name:CLOONAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:595 N DOBSON RD
Mailing Address - Street 2:D76
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4226
Mailing Address - Country:US
Mailing Address - Phone:480-821-0788
Mailing Address - Fax:480-821-0837
Practice Address - Street 1:595 N DOBSON RD
Practice Address - Street 2:D76
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4226
Practice Address - Country:US
Practice Address - Phone:480-821-0788
Practice Address - Fax:480-821-0837
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29046207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0756270OtherBCBS
AZ597148Medicaid
AZ2Z0897OtherHEALTHNET
AZAZ0756270OtherBCBS
H52441Medicare UPIN