# NICK MELLIS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NICHOLAS MELLIS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518298389
- **Legal business name:** NICHOLAS MELLIS
- **Authorized official:** NICK MELLIS (OWNER)
- **Authorized official phone:** (410) 560-5652

## Contact information

- **Practice address:** 2352 YORK RD, TIMONIUM, MD 21093-2236
- **Practice address phone:** (410) 560-5652
- **Mailing address:** 2352 YORK RD, TIMONIUM, MD 21093-2236
- **Mailing address phone:** (410) 560-5652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0047762 | MD | Yes |

## Other

- **Enumeration date:** 01/19/2010
- **Last updated:** 09/26/2011