Kent E Mellerstig, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G18760 Issued in CA

Practice address

1043 Slate Dr
Santa Rosa, CA 95405-8841

Phone

(707) 527-7211

Fax

(707) 538-7044

NPI assigned

Nov 23, 2005

Last updated

Oct 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1649253659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 SLATE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058841",
            "telephone_number": "707-527-7211",
            "fax_number": "707-538-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 SLATE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058841",
            "telephone_number": "707-527-7211",
            "fax_number": "707-538-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLERSTIG",
        "first_name": "KENT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G18760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esmeralda Mejia Perez
• Robert Mejia Powell, MD
• Jaqueline Mejia, CERTIFICATE
• Jenna Melao
• Rosemary Laura Melchor, M.A.
• Patricia N. Melosh
• Charles J. Meltzer, MD
• Zoe Memel, MD
• Amanda Johanna Menary
• Diana Mendelson

• Plastic Surgery Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.