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NPI Code Detail

MEDICARE: MARK A. MELISH, M.D., P.A.

MEDICARE: MARK A. MELISH, M.D., P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianG8278TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2050009511OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100B60TOTHERTXBCBS TEXAS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4103527100OTHERTXUSDOL

General Provider Information

NPI Number : 1437254547
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK A. MELISH, M.D., P.A.
Provider Business Mailing Address
First Line : PO BOX 29384
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-0384
Country : US
Telephone Number : 210-227-5168
Fax Number : 210-224-6945
Provider Business Practice Location Address
First Line : 621 N ALAMO ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-1836
Country : US
Telephone Number : 210-227-5223
Fax Number : 210-224-6945
Authorized Official
Title or Position : OWNER
Name : DR. MARK A MELISH
Credential : M.D.
Telephone Number : 210-227-5223
Provider Enumeration Date : 09/13/2006
Last Update Date : 06/16/2015

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