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General NPI Number Information
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NPI Number | 1639157688
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Entity Type | Individual
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Provider Name | MELANIE ELIZABETH JUNGBLUT MD
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Gender | Female
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 950 S MAIN ST STE 5
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City | CELINA
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State | OH
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Zip | 45822-2467
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Country | US
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Telephone | 567-890-7163
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Fax | 567-890-7193
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Provider Business Mailing Address
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Address Line | 830 W MAIN ST
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City | COLDWATER
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State | OH
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Zip | 45828-1626
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Country | US
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Telephone | 567-890-7143
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Fax | 419-586-0812
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35062650J
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License Number State | OH
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