Provider Demographics
NPI:1265883615
Name:KAPPADAKUNNEL, MELANIE (DO)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:KAPPADAKUNNEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 RESEARCH PL STE 220
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2455
Mailing Address - Country:US
Mailing Address - Phone:978-459-6737
Mailing Address - Fax:855-818-1869
Practice Address - Street 1:20 RESEARCH PL STE 220
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2455
Practice Address - Country:US
Practice Address - Phone:978-459-6737
Practice Address - Fax:855-818-1869
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151009410207R00000X
MA291745207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine