NPI 1013080787 · live from the CMS NPI Registry
Michael Gerardo Melendez, MD
Radiology, Diagnostic Radiology in Coeur D Alene, ID. National Provider Identifier 1013080787, active.
NPI record
| NPI | 1013080787 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 2789 E Spyglass Ct, Coeur D Alene, ID 83815 |
| Practice phone | 208-610-0041 |
| Enumerated | November 17, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | M-3755 (ID) |
| Radiology, Diagnostic Radiology | 2085R0202X | 160913-1205 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.