# SERGIO ALEJANDRO CARRILLO MELENDEZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801922307
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | 35-134059 | OH | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 15567 | NV | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 35-134059 | OH | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 03/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0292924 | — | OH |
| 05 | — | 1801922307 | — | NV |
| 01 | — | H644990 | CGS - MEDICARE | OH |