Healthcare Provider Details

I. General information

NPI: 1770788663
Provider Name (Legal Business Name): MELANIE BROOKE HAYES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE BROOKE GATEWOOD MD

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 S EAST ST STE C
INDIANAPOLIS IN
46227-1991
US

IV. Provider business mailing address

4468 THICKET TRCE
ZIONSVILLE IN
46077-9687
US

V. Phone/Fax

Practice location:
  • Phone: 317-534-4660
  • Fax: 317-782-4301
Mailing address:
  • Phone: 317-490-4033
  • Fax: 317-782-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01068936A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: