Healthcare Provider Details

I. General information

NPI: 1346258951
Provider Name (Legal Business Name): MELISSA KAHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 WILLIAMS BLVD
CEDAR RAPIDS IA
52404
US

IV. Provider business mailing address

4325 WILLIAMS BLVD
CEDAR RAPIDS IA
52404
US

V. Phone/Fax

Practice location:
  • Phone: 319-368-8400
  • Fax: 319-396-3183
Mailing address:
  • Phone: 319-368-8400
  • Fax: 319-396-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36262
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD36262
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0762419
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 2
Identifier0450569
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: