Healthcare Provider Details

I. General information

NPI: 1306005152
Provider Name (Legal Business Name): MELODEE SUE WOODARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SW 7TH ST
DES MOINES IA
50309-4535
US

IV. Provider business mailing address

2884 CUMMING RD
VAN METER IA
50261-8511
US

V. Phone/Fax

Practice location:
  • Phone: 515-725-0831
  • Fax:
Mailing address:
  • Phone: 515-981-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25298
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: