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1962607820

NPI Code Detail

MEDICARE: MELISSA DAWN LAH MD

MEDICARE: MELISSA DAWN LAH MD

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	207SG0201X	Clinical Genetics (M.D.) Physician	01068482A	IN
2	208000000X	Pediatrics Physician	01068482A	IN
3	207SG0203X	Clinical Molecular Genetics Physician	01068482A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000001012005	OTHER	IN	ANTHEM PTAN

General Provider Information

NPI Number	:	1962607820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA DAWN LAH MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 WISHARD BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-4163
Country	:	US
Telephone Number	:	317-944-3966
Fax Number	:	317-968-1354

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	02/21/2025

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Directions to “ MELISSA DAWN LAH MD” Practice Location

Language	Start Address	Practice Location

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