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General NPI Number Information
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NPI Number | 1982705059
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Entity Type | Individual
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Provider Name | LORI L W MELBY MD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 5450 LYNDALE AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-1718
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Country | US
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Telephone | 888-290-1209
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Fax | 833-973-3528
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Provider Business Mailing Address
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Address Line | 1981 RASPBERRY LN
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City | SHAKOPEE
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State | MN
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Zip | 55379-4584
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Country | US
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Telephone | 612-868-6967
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 37268
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License Number State | MN
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