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General NPI Number Information
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NPI Number | 1508056474
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Entity Type | Individual
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Provider Name | DAVID S. MELMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 5 N MAIN ST
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City | ENFIELD
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State | CT
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Zip | 06082-3372
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Country | US
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Telephone | 860-253-9024
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Fax | 860-253-9593
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Provider Business Mailing Address
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Address Line | 575 MAIN STREET 2ND FLOOR ATTN: CREDENTIALING DEPT
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City | MIDDLETOWN
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State | CT
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Zip | 06457
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Country | US
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Telephone | 860-347-6971
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD18160
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 044356
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License Number State | CT
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