Provider Demographics
NPI:1134694813
Name:MONTEITH, MELANIE DAWN (RD, CD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:DAWN
Last Name:MONTEITH
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:DAWN
Other - Last Name:STURM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD,CD
Mailing Address - Street 1:720 ESKENAZI AVE
Mailing Address - Street 2:FIFTH THIRD BANK BLDG, 5TH FL
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-4166
Mailing Address - Country:US
Mailing Address - Phone:317-880-4121
Mailing Address - Fax:317-880-4121
Practice Address - Street 1:720 ESKENAZI AVE FL 2
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5189
Practice Address - Country:US
Practice Address - Phone:317-880-7000
Practice Address - Fax:317-880-0526
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002968A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered