Provider Demographics
NPI:1790542397
Name:MECHAS, MADALYN MARIE
Entity Type:Individual
Prefix:
First Name:MADALYN
Middle Name:MARIE
Last Name:MECHAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADALYN
Other - Middle Name:MARIE
Other - Last Name:WIEFERING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:622 W MAIN ST APT 109
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2090
Mailing Address - Country:US
Mailing Address - Phone:513-824-4576
Mailing Address - Fax:
Practice Address - Street 1:622 W MAIN ST APT 109
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2090
Practice Address - Country:US
Practice Address - Phone:513-824-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program