1316945009 NPI number — DR. MELISSA DIANE YOUNG-SZALAY MD

Table of content: DR. MELISSA DIANE YOUNG-SZALAY MD (NPI 1316945009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316945009 NPI number — DR. MELISSA DIANE YOUNG-SZALAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YOUNG-SZALAY
Provider First Name:
MELISSA
Provider Middle Name:
DIANE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316945009
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9500 UNIVERSITY AVE STE 1107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50266-1870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-216-0898
Provider Business Mailing Address Fax Number:
872-241-0269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 UNIVERSITY AVE STE 1107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50266-1870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-212-6089
Provider Business Practice Location Address Fax Number:
872-241-0269
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207XS0106X , with the licence number:  33570 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 19293 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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