MRS. Mary Melanie Waller, MD

NPI #1225024615 in Olney, Illinois

Provider Information

NPI Number: 1225024615
Entity Type: Individual
Name: MRS. Mary Melanie Waller, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Urology
Credential: MD
Enumeration Date: Sep 21, 2005
Last Updated: Oct 5, 2009

Practice Location

Address: 1200 N EAST ST
City: Olney
State: Illinois
ZIP Code: 62450-2432
Phone: (618) 395-5222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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