MEDICARE: SCOTT R MELLING O.D.

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	152W00000X	Optometrist	OD-988	ID

General Provider Information

NPI Number	:	1972572766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT R MELLING O.D.

Provider Business Mailing Address
First Line	:	CMR 470 BOX 4871
Second Line	:
City	:	APO
State	:	AE
Zip	:	09165
Country	:	DE
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	HANAU HEALTH CLINIC ATTN: OPTOMETRY
Second Line	:	UNIT 20193 BOX 0030
City	:	APO
State	:	AE
Zip	:	09165
Country	:	DE
Telephone Number	:	061815006605
Fax Number	:

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	07/08/2007

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Directions to “ SCOTT R MELLING O.D.” Practice Location

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