Healthcare Provider Details

I. General information

NPI: 1407876808
Provider Name (Legal Business Name): RAUN MELMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4848 E CACTUS RD STE 940
SCOTTSDALE AZ
85254-4164
US

IV. Provider business mailing address

12400 N TATUM BLVD UNIT 2024
PHOENIX AZ
85032-0034
US

V. Phone/Fax

Practice location:
  • Phone: 480-443-0050
  • Fax:
Mailing address:
  • Phone: 480-205-7903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number13127
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: