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NPI Code Detail

MEDICARE: SUSAN MELLER

MEDICARE: SUSAN MELLER
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
1207Q00000XFamily Medicine PhysicianOS012125PA
2207Q00000XFamily Medicine PhysicianT4557TX
3207Q00000XFamily Medicine Physician17892CA
4207Q00000XFamily Medicine Physician91285SC
5207Q00000XFamily Medicine Physician25MB11418600NJ
6207Q00000XFamily Medicine Physician02006612AIN
7207R00000XInternal Medicine PhysicianOS012125PA
8207R00000XInternal Medicine PhysicianDO3045NV
9207Q00000XFamily Medicine PhysicianOS18229FL

General Provider Information

NPI Number : 1538177316
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MELLER
Provider Business Mailing Address
First Line : 415 CHAPEL RD
Second Line :
City : ELKINS PARK
State : PA
Zip : 19027-2504
Country : US
Telephone Number : 215-287-0412
Fax Number :
Provider Business Practice Location Address
First Line : 2300 W SAHARA AVE STE 800
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4397
Country : US
Telephone Number : 203-666-8145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 10/07/2024

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Directions to “ SUSAN MELLER ” Practice Location

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