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General NPI Number Information
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NPI Number | 1649454539
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Entity Type | Individual
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Provider Name | MELANIE RAE LIND-AYRES M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 33 JESSE HILL JUNIOR DRIVE SOUTHEAST
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City | ATLANTA
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State | GA
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Zip | 30303
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Country | US
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Telephone | 404-778-1440
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Fax | 404-778-1401
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Provider Business Mailing Address
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Address Line | 1110 CREEKDALE DR
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City | CLARKSTON
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State | GA
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Zip | 30021-1023
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Country | US
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Telephone | 404-294-0231
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 002079
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License Number State | GA
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