Provider Demographics
NPI:1063419109
Name:MELEAN, JAIME R (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:R
Last Name:MELEAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1431 BLUFFVIEW ST
Mailing Address - Street 2:STE 112
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3039
Mailing Address - Country:US
Mailing Address - Phone:316-688-0321
Mailing Address - Fax:316-688-0728
Practice Address - Street 1:1431 BLUFFVIEW ST
Practice Address - Street 2:STE 112
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3039
Practice Address - Country:US
Practice Address - Phone:316-688-0321
Practice Address - Fax:316-688-0728
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0417617207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS000022OtherBCBS
KS480940604OtherTAXI ID #
KS100092950AMedicaid
KS100092950AMedicaid
KS003961Medicare ID - Type Unspecified