Healthcare Provider Details

I. General information

NPI: 1407838295
Provider Name (Legal Business Name): SAMIR A MELKI M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 07/03/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 WEBSTER PL
BROOKLINE MA
02445-7937
US

IV. Provider business mailing address

24 WEBSTER PL
BROOKLINE MA
02445-7937
US

V. Phone/Fax

Practice location:
  • Phone: 617-202-2020
  • Fax: 617-734-3264
Mailing address:
  • Phone: 617-202-2020
  • Fax: 617-734-3264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number156694
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: