NPI Code Details Logo

NPI 1619932654

NPI 1619932654 : ROBERT J MELECA M.D., FACS : WYOMING, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1619932654
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ROBERT J MELECA M.D., FACS
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/20/2006
-----------------------------------------------------
    Last Update Date     |    12/02/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1555 44TH ST SW 
-----------------------------------------------------
    City                 |    WYOMING
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    49509-4395
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    616-249-8000
-----------------------------------------------------
    Fax                  |    616-249-8088
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1555 44TH ST SW 
-----------------------------------------------------
    City                 |    WYOMING
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    49509-4313
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    616-307-7904
-----------------------------------------------------
    Fax                  |    616-307-7904
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Y00000X
-----------------------------------------------------
    Taxonomy Name        |    Otolaryngology Physician
-----------------------------------------------------
    License Number       |    SPCV105320
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.