Healthcare Provider Details

I. General information

NPI: 1265466809
Provider Name (Legal Business Name): MELISSA ANN GELLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MINNESOTA PHYSICIANS 516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1C
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

720 WASHINGTON AVE SE UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS MN
55414
US

V. Phone/Fax

Practice location:
  • Phone: 612-626-3444
  • Fax:
Mailing address:
  • Phone: 612-626-3111
  • Fax: 612-626-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number44543
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number44543
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: