Provider Demographics
NPI:1316983588
Name:ATWOOD, MELONY COVINGTON (MD)
Entity type:Individual
Prefix:
First Name:MELONY
Middle Name:COVINGTON
Last Name:ATWOOD
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:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1380 E MEDICAL CTR DR STE H
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2123
Practice Address - Country:US
Practice Address - Phone:435-868-5570
Practice Address - Fax:435-868-5575
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400478207R00000X, 207RC0000X
UT9889946-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891362XMedicaid
P00326037OtherMEDICARE RAILROAD
NC1316983588Medicaid
NC1362XOtherBCBS
SCN0047CMedicaid
NC891362XMedicaid
NC1362XOtherBCBS
NCI10127Medicare UPIN
SCN0047CMedicaid