Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MT199350 | PA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 036.140210 | IL |
NPI | 1205128030 |
---|---|
Provider Name | Christopher Michael Melnic |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 22/06/2016 |