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General NPI Number Information
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NPI Number | 1255352209
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Entity Type | Organization
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Legal Business Name | DAVID A MELLUL DPM
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 200 KINGS HWY S
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2506
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Country | US
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Telephone | 856-429-9009
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Fax | 856-429-8400
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Provider Business Mailing Address
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Address Line | 200 KINGS HWY S
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2506
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Country | US
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Telephone | 856-429-9009
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Fax | 856-429-8400
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DAVID A MELLUL
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Credential | D.P.M.
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Telephone | 856-429-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MD1488
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License Number State | NJ
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