Provider Demographics
NPI:1295861144
Name:MELENDEZ, MISAEL D (DC)
Entity type:Individual
Prefix:DR
First Name:MISAEL
Middle Name:D
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3331 HAMILTON MILL RD
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4096
Mailing Address - Country:US
Mailing Address - Phone:678-889-2220
Mailing Address - Fax:678-804-9182
Practice Address - Street 1:3331 HAMILTON MILL RD
Practice Address - Street 2:SUITE 1102
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4096
Practice Address - Country:US
Practice Address - Phone:678-889-2220
Practice Address - Fax:678-804-9182
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8624111N00000X
GACHIR008572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor