Healthcare Provider Details

I. General information

NPI: 1295034767
Provider Name (Legal Business Name): MELANIE MARIE KREINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 BLUE RIDGE RD SUITE 100
RALEIGH NC
27607-6678
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 919-786-5001
  • Fax: 919-786-5051
Mailing address:
  • Phone: 614-722-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2014-00940
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: