Provider Demographics
NPI:1578859351
Name:MUND, MELANIE BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:BETH
Last Name:MUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 STRAITS TPKE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2846
Mailing Address - Country:US
Mailing Address - Phone:203-575-1611
Mailing Address - Fax:
Practice Address - Street 1:687 STRAITS TPKE
Practice Address - Street 2:SUITE 2A
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2846
Practice Address - Country:US
Practice Address - Phone:203-575-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054319207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology