Provider Demographics
NPI:1124080312
Name:MELLO, CURTIS J (MD)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:J
Last Name:MELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 FAUNCE CORNER RD
Mailing Address - Street 2:FL 2
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1271
Mailing Address - Country:US
Mailing Address - Phone:774-929-9100
Mailing Address - Fax:774-929-6290
Practice Address - Street 1:370 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1271
Practice Address - Country:US
Practice Address - Phone:508-999-5666
Practice Address - Fax:508-999-5151
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07880207RP1001X
MA79856207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110054549AMedicaid
MAS400133977Medicare PIN
RI007010016Medicare PIN
MAJ14676OtherBCBS-MA
MA3125874Medicaid
MA69584OtherHARVARD-PILGRIM HEALTHCARE
MAJ14676Medicare PIN