Provider Demographics
NPI:1780298794
Name:MCELWAIN, MELYNDA MARIE
Entity type:Individual
Prefix:
First Name:MELYNDA
Middle Name:MARIE
Last Name:MCELWAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4346
Mailing Address - Country:US
Mailing Address - Phone:405-226-8978
Mailing Address - Fax:
Practice Address - Street 1:2605 GLEN OAKS DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4346
Practice Address - Country:US
Practice Address - Phone:405-226-8978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist