Provider Demographics
NPI:1386693331
Name:MELGEN, VICTOR WADY (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:WADY
Last Name:MELGEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:765 IMAGE WAY
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763
Practice Address - Country:US
Practice Address - Phone:386-774-7411
Practice Address - Fax:386-774-7412
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME52934207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL035004400Medicaid
FL07806OtherBLUE CROSS BLUE SHIELD
FL1227562OtherUNITED HEALTHCARE
FL700979OtherHMO
FLP00178570OtherPALMETTO GBA
FL4534587OtherAETNA PPO
FLME 52934OtherMEDICAL LICENSE
FL006583OtherFLORIDA HEALTHCARE
FL214866OtherAVMED HEALTHCARE
FL3968419008OtherCIGNA HEALTHCARE
FL1227562OtherUNITED HEALTHCARE
FLP00178570OtherPALMETTO GBA
FL07806UMedicare PIN