Provider Demographics
NPI:1629058953
Name:VIOLAND, MELANIE A (DPM)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:VIOLAND
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5232
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85376-5232
Mailing Address - Country:US
Mailing Address - Phone:623-584-6500
Mailing Address - Fax:623-584-6335
Practice Address - Street 1:14418 W MEEKER BLVD
Practice Address - Street 2:STE 207
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5283
Practice Address - Country:US
Practice Address - Phone:623-584-6500
Practice Address - Fax:623-584-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0646213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ138945Medicare PIN
U96031Medicare UPIN