Mark Edward Mcmellen M.D.

NPI 1053597955 - Surgery - 208600000X

NPI Details
NPI 1053597955
Gender Male
Enumeration Date 01/10/2008
Last Updated 06/06/2011
Entity Type Individual
Active Over 8 years ago
Practice Location
3635 VISTA AVE
DEPT. OF SURGERY
SAINT LOUIS MO, 63110-2539, US
Phone (314) 577-8317
Fax
Business Location
3635 VISTA AVE
DEPT. OF SURGERY
SAINT LOUIS MO, 63110-2539, US
Phone (314) 577-8317
Fax
Toxanomy
Taxonomy Code 208600000X
License State Missouri
License Number 2009012459
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According to our database, Dr. Mark Edward Mcmellen M.D. NPI is 1053597955, taxonomy code is 208600000X and license number is 2009012459, license state is located at Missouri. Mark Edward Mcmellen M.D. physically located at 3635 Vista Ave, Saint Louis MO, 63110-2539. NPI Number Mark Edward Mcmellen M.D. has the Individual type.

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1053597955 NPI number is provided on an as is basis without warranty of any kind. 1053597955 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Edward Mcmellen M.D. are for informational purposes only.