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General NPI Number Information
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NPI Number | 1437312477
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Entity Type | Individual
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Provider Name | MELVY S MATHEW
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2355 HWY 36 W STE. 100
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 652-292-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2355 HWY 36 W STE. 100
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 652-292-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 22320
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 79345
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036135204
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 13397-320
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 325386
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License Number State | NY
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