MEDICARE: DR. MELINDA MILLER GARDNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD8400	DC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0246160001	OTHER	DC	DMERC ADMINISTAR MEDICARE

General Provider Information

NPI Number	:	1053316422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELINDA MILLER GARDNER M.D.

Provider Business Mailing Address
First Line	:	3301 NEW MEXICO AVE NW
Second Line	:	STE 248
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3610
Country	:	US
Telephone Number	:	202-244-0706
Fax Number	:	202-686-6278

Provider Business Practice Location Address
First Line	:	3301 NEW MEXICO AVE NW
Second Line	:	STE 248
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3610
Country	:	US
Telephone Number	:	202-244-0706
Fax Number	:	202-686-6278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/09/2007

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