Provider Demographics
NPI:1821198607
Name:MACLIN, MELVIN MARLOW II (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:MARLOW
Last Name:MACLIN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 NELDA AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5438
Mailing Address - Country:US
Mailing Address - Phone:314-398-4826
Mailing Address - Fax:314-569-3674
Practice Address - Street 1:3009 N BALLAS RD STE 100B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-432-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20030208342086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00070969OtherRR MEDICARE
MOP00070969OtherRR MEDICARE