Healthcare Provider Details

I. General information

NPI: 1700927589
Provider Name (Legal Business Name): MELISSA ANDREWS LINDENAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 N COMANCHE AVE
OKLAHOMA CITY OK
73132
US

IV. Provider business mailing address

7301 N COMANCHE AVE
OKLAHOMA CITY OK
73132
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4646
  • Fax: 405-271-4242
Mailing address:
  • Phone: 405-271-4646
  • Fax: 405-271-4242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23958
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: