Healthcare Provider Details

I. General information

NPI: 1912218256
Provider Name (Legal Business Name): MELANIE VIOLAND DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14418 W MEEKER BLVD BLDG B, STE 207
SUN CITY WEST AZ
85375-5283
US

IV. Provider business mailing address

PO BOX 5232
SUN CITY WEST AZ
85376-5232
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-6500
  • Fax: 623-584-6335
Mailing address:
  • Phone: 623-584-6500
  • Fax: 623-584-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0646
License Number StateAZ

VIII. Authorized Official

Name: MELANIE A VIOLAND
Title or Position: MEMBER/OWNER
Credential: DPM
Phone: 623-584-6500