Provider Demographics
NPI:1780074880
Name:DEMARCE, MELANIE Z (PA-C)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:Z
Last Name:DEMARCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3311 E MURDOCK ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3054
Mailing Address - Country:US
Mailing Address - Phone:316-274-8616
Mailing Address - Fax:316-274-8909
Practice Address - Street 1:3311 E MURDOCK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208
Practice Address - Country:US
Practice Address - Phone:316-274-8616
Practice Address - Fax:316-274-8909
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ191442Medicare PIN