MEDICARE: MELODY M COLE MS RD CD

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	133V00000X	Registered Dietitian	1608	WI

General Provider Information

NPI Number	:	1568421642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY M COLE MS RD CD

Provider Business Mailing Address
First Line	:	7974 UW HEALTH CT
Second Line	:
City	:	MIDDLETON
State	:	WI
Zip	:	53562-5531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 S PARK ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1348
Country	:	US
Telephone Number	:	608-287-2780
Fax Number	:	608-287-2777

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	03/02/2009

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