Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 270515 | NY |
N | 204F00000X | Transplant Surgeon | D62233 | MD |
Y | 204F00000X | Transplant Surgeon | MD037319 | DC |
N | 208200000X | Surgeon | 270515 | NY |
N | 208600000X | Surgeon | 270515 | NY |
NPI | 1760432108 |
---|---|
Provider Name | Joseph Keith Melancon |
First Address | Washington, DC 20037-1888 |
Second Address | Washington, DC 20037-1888 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03687809 | (05) | NY |
405991300 | (05) | MD |
H77339 | (02) | MD |
P00894808 | RAILROAD MEDICARE (01) | DC |