MEDICARE: DR. DANIEL F MELVILLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	80675	MA

General Provider Information

NPI Number	:	1346241569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL F MELVILLE MD

Provider Business Mailing Address
First Line	:	545 A CENTRE ST
Second Line	:	BETH ISRAEL DEACONESS HEALTH CARE - JAMAICA PLAIN
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-2071
Country	:	US
Telephone Number	:	617-522-5464
Fax Number	:	617-524-2966

Provider Business Practice Location Address
First Line	:	545 A CENTRE ST
Second Line	:	BETH ISRAEL DEACONESS HEALTH CARE - JAMAICA PLAIN
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-2071
Country	:	US
Telephone Number	:	617-522-5464
Fax Number	:	617-524-2966

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/14/2011

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