Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 06224R | LA |
NPI | 1609002799 |
---|---|
Provider Name | Dr. Michael Philip Melcher |
First Address | Alexandria, LA 71303-4405 |
Second Address | Alexandria, LA 71303-4405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 03/06/2009 |