Provider Demographics
NPI:1609905835
Name:ANDERSON, MELANIE SUE (HEALTH SERVICES TECH)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SUE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:HEALTH SERVICES TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 CROSSROADS DR
Mailing Address - Street 2:APT# 16G
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9437
Mailing Address - Country:US
Mailing Address - Phone:517-614-3021
Mailing Address - Fax:
Practice Address - Street 1:1050 REGISTER ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-2421
Practice Address - Country:US
Practice Address - Phone:843-308-9662
Practice Address - Fax:843-308-0293
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other