Provider Demographics
NPI:1861488355
Name:BRIONES, MELBA CALDERON (MD)
Entity Type:Individual
Prefix:MRS
First Name:MELBA
Middle Name:CALDERON
Last Name:BRIONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0147
Mailing Address - Country:US
Mailing Address - Phone:812-469-6800
Mailing Address - Fax:
Practice Address - Street 1:3400 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0147
Practice Address - Country:US
Practice Address - Phone:812-469-6800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032873A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN941740OMedicare ID - Type UnspecifiedMEDICARE
IND47503Medicare UPIN