Provider Demographics
NPI:1720320179
Name:SCHEEFER, MELODY (MD)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:SCHEEFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:SCHEEFER
Other - Last Name:VAN BOERUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1725 E MURRAY HOLLADAY RD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5589
Mailing Address - Country:US
Mailing Address - Phone:385-315-0145
Mailing Address - Fax:
Practice Address - Street 1:1725 E MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5589
Practice Address - Country:US
Practice Address - Phone:385-315-0145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9149575-1205208200000X, 208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery