Provider Demographics
NPI:1932544665
Name:ADAMS-BOYLE, MELANIE DAWN (DO)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:DAWN
Last Name:ADAMS-BOYLE
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:PO BOX 10121
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-0121
Mailing Address - Country:US
Mailing Address - Phone:602-329-2710
Mailing Address - Fax:
Practice Address - Street 1:33400 N 32ND AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8876
Practice Address - Country:US
Practice Address - Phone:602-329-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007828208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0348899OtherGROUP MEDICAID
NJ216927OtherGROUP MEDICARE
NJ216927OtherGROUP MEDICARE