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General NPI Number Information
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NPI Number | 1063412898
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Entity Type | Individual
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Provider Name | JOSE ENRIQUE MELENDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 1061 HARMON AVE
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City | FORT STEWART
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State | GA
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Zip | 31314-5604
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Country | US
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Telephone | 912-435-6331
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Fax |
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Provider Business Mailing Address
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Address Line | X1061 HARMON AVE 1DO3, WINN ARMY COMMUNITY HOSPITAL,
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City | FORT STEWART
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State | GA
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Zip | 31314-5604
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Country | US
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Telephone | 912-435-6331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D0042409
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License Number State | MD
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