Provider Demographics
NPI:1427007921
Name:CARDOZA, MELANIE L (DO)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:L
Last Name:CARDOZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MILLIKEN BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721
Mailing Address - Country:US
Mailing Address - Phone:508-674-5200
Mailing Address - Fax:508-675-1719
Practice Address - Street 1:211 MILLIKEN BLVD
Practice Address - Street 2:STE A
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721
Practice Address - Country:US
Practice Address - Phone:508-674-5200
Practice Address - Fax:508-675-1719
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA217023207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9784888Medicaid
H91177Medicare UPIN
MA9784888Medicaid