Healthcare Provider Details

I. General information

NPI: 1942201306
Provider Name (Legal Business Name): MICHAEL J MELECA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 DILEY RD SUITE 140
CANAL WINCHESTER OH
43110-9612
US

IV. Provider business mailing address

7901 DILEY RD SUITE 140
CANAL WINCHESTER OH
43110-9612
US

V. Phone/Fax

Practice location:
  • Phone: 614-920-3410
  • Fax: 614-920-3413
Mailing address:
  • Phone: 614-920-3410
  • Fax: 614-920-3413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35064803
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number35064803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: