Provider Demographics
NPI:1932262110
Name:CRUZE, MELANIE SHUEY (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SHUEY
Last Name:CRUZE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:1001 G ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4545
Practice Address - Country:US
Practice Address - Phone:202-660-0005
Practice Address - Fax:202-660-0025
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2024-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA9722363A00000X
DCPA031138363A00000X
NC0010-10178363A00000X
TXPA17323363A00000X
MDC003058363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant