Provider Demographics
NPI:1184417602
Name:CASTRO MOLLO, MELANIE WENDY (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:WENDY
Last Name:CASTRO MOLLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JIRON PIETRO TORRIGIANO 109-DPTO 1102
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:LIMA
Mailing Address - Zip Code:15036
Mailing Address - Country:PE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA ANGAMOS 2520
Practice Address - Street 2:
Practice Address - City:LIME
Practice Address - State:LIMA
Practice Address - Zip Code:15038
Practice Address - Country:PE
Practice Address - Phone:617-582-8410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program