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MELISSA ELAINE LUCARELLI MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1336102169

Individual Registrant:
 MELISSA ELAINE LUCARELLI MD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
504 S HIGH STREET  RANDOLPH, WI 53956 US
Tel: 920-326-5060  Fax: 920-326-5061

Contact information for business:
504 S HIGH ST PO BOX 101 RANDOLPH, WI 53956-1499 US
Tel: 920-326-5060  Fax: 920-326-5061

Registration Information:
NPI: 1336102169
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
WI36988020

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DEAN HEALTH PLAN11573WI01
RAILROAD MEDICARE08017446501
32327000WI05




HEALTH CARE JOBS WI - Page 1



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