Provider Demographics
NPI:1518700582
Name:MCDONALD, MELANIE (NCPT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:NCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 RIDGEWAY CENTER PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-4014
Mailing Address - Country:US
Mailing Address - Phone:855-522-2968
Mailing Address - Fax:
Practice Address - Street 1:5865 RIDGEWAY CENTER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4014
Practice Address - Country:US
Practice Address - Phone:855-522-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN878039246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy