1144455221 NPI number — MICHAEL J. MELECA, MD, LLC

Table of content: (NPI 1144455221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144455221 NPI number — MICHAEL J. MELECA, MD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL J. MELECA, MD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EAST COLUMBUS CARDIOLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144455221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1680 EAGLE GLEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLACKLICK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43004-9622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-496-2106
Provider Business Mailing Address Fax Number:
614-866-4618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
417 HILL ROAD NORTH
Provider Second Line Business Practice Location Address:
SUITE 801
Provider Business Practice Location Address City Name:
PICKERINGTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-920-3410
Provider Business Practice Location Address Fax Number:
614-920-3413
Provider Enumeration Date:
05/19/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MELECA
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRACTICE OWNER
Authorized Official Telephone Number:
614-496-2106

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  35-064803 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0901X , with the licence number: 35-064803 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)