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General NPI Number Information
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NPI Number | 1497168363
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Entity Type | Individual
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Provider Name | ALLISON MELONI
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Gender | Female
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Dates
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Enumeration Date | 06/08/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 1557 JANMAR RD
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City | SNELLVILLE
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State | GA
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Zip | 30078-5686
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Country | US
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Telephone | 678-344-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 FAIRCREST LN
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City | ALPHARETTA
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State | GA
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Zip | 30004-0582
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Country | US
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Telephone | 724-825-1696
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 007198
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 7198
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License Number State | GA
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