Provider Demographics
NPI:1487691747
Name:LEMELLE, DONALD PIERRE (DPM)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PIERRE
Last Name:LEMELLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W HARDING RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1706
Mailing Address - Country:US
Mailing Address - Phone:937-399-8011
Mailing Address - Fax:937-399-7096
Practice Address - Street 1:415 W HARDING RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1706
Practice Address - Country:US
Practice Address - Phone:937-399-8011
Practice Address - Fax:937-399-7096
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002452213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0695823Medicaid
OH00000035080OtherANTHEM
OHT80660Medicare UPIN
OH0695823Medicaid
OH0144040001Medicare NSC