Provider Demographics
NPI:1417510173
Name:ROOKWOOD, MELANIE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:D
Last Name:ROOKWOOD
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 1:16759 MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1232
Mailing Address - Country:US
Mailing Address - Phone:636-458-4800
Mailing Address - Fax:
Practice Address - Street 1:16759 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1232
Practice Address - Country:US
Practice Address - Phone:636-458-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018034281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty