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General NPI Number Information
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NPI Number | 1861435208
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Entity Type | Individual
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Provider Name | JEAN ALLEN MELVIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 3111 SPRINGBANK LN SUITE G
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City | CHARLOTTE
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State | NC
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Zip | 28226-3372
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Country | US
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Telephone | 704-644-7885
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Fax | 704-353-7275
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Provider Business Mailing Address
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Address Line | 3111 SPRINGBANK LANE SUITE G
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City | CHARLOTTE
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State | NC
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Zip | 28226-3373
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Country | US
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Telephone | 704-644-7885
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Fax | 704-353-7275
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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 | 31951
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License Number State | NC
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