MEDICARE: MELANIE W CONWAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	E-1763	AR

General Provider Information

NPI Number	:	1528051687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE W CONWAY MD

Provider Business Mailing Address
First Line	:	1405 N PIERCE ST STE 307
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207-5377
Country	:	US
Telephone Number	:	501-773-3329
Fax Number	:	331-204-0856

Provider Business Practice Location Address
First Line	:	1405 NORTH PIERCE
Second Line	:	SUITE 212
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207
Country	:	US
Telephone Number	:	501-664-0091
Fax Number	:	501-664-0112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/14/2021

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