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NPI Code Detail

MEDICARE: DR. MELANIE A SMITH DO

MEDICARE: DR. MELANIE A SMITH DO
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
1207Q00000XFamily Medicine Physician39961WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568579779
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELANIE A SMITH DO
Provider Business Mailing Address
First Line : 3301 W FOREST HOME AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-2843
Country : US
Telephone Number : 262-514-3700
Fax Number : 262-514-3867
Provider Business Practice Location Address
First Line : 818 FOREST LN
Second Line :
City : WATERFORD
State : WI
Zip : 53185-4585
Country : US
Telephone Number : 262-514-3700
Fax Number : 262-514-3867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 03/07/2023

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