Healthcare Provider Details

I. General information

NPI: 1821317892
Provider Name (Legal Business Name): ANDREW-PETER DRURY MELONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 S MEADOWS PKWY
RENO NV
89521-3861
US

IV. Provider business mailing address

748 S MEADOWS PKWY
RENO NV
89521-3861
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-4042
  • Fax:
Mailing address:
  • Phone: 775-324-4042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number14804
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: