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General NPI Number Information
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NPI Number | 1861563421
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Entity Type | Individual
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Provider Name | ANIBAL GONCALVES MELO MD
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 224 S WOODS MILL RD STE 460S
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3608
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Country | US
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Telephone | 314-682-6500
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Fax | 314-552-7276
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Provider Business Mailing Address
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Address Line | 224 S WOODS MILL RD STE 460S
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3608
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Country | US
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Telephone | 314-682-6500
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Fax | 314-552-7276
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 112089
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 036097259
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License Number State | IL
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