Provider Demographics
NPI:1629203179
Name:ELFRINK, MELANIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:E
Last Name:ELFRINK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2305 SOUTH 65 HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-3702
Mailing Address - Country:US
Mailing Address - Phone:660-888-7431
Mailing Address - Fax:660-886-9001
Practice Address - Street 1:2305 SOUTH 65 HIGHWAY
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3702
Practice Address - Country:US
Practice Address - Phone:660-888-7431
Practice Address - Fax:660-831-3335
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2021-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8H95207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1629203179Medicaid
MOX43000018Medicare Oscar/Certification
E75000011Medicare Oscar/Certification