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NPI Code Detail

MEDICARE: GEORGE A. MELONE JR. M.D.

MEDICARE: GEORGE A. MELONE JR. M.D.
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
1207P00000XEmergency Medicine Physician32793NC
2390200000XStudent in an Organized Health Care Education/Training Program
3207RG0300XGeriatric Medicine (Internal Medicine) Physician0061314CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
258590OTHERNCBLUECROSS BLUESHIELD

General Provider Information

NPI Number : 1780659573
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE A. MELONE JR. M.D.
Provider Business Mailing Address
First Line : 5730 EXECUTIVE DR STE 230
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1762
Country : US
Telephone Number : 410-402-2379
Fax Number :
Provider Business Practice Location Address
First Line : 3235 MILL VISTA RD
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-2440
Country : US
Telephone Number : 303-876-8320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 06/15/2022

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