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Individual

DR. MARK EDWARD MCMELLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2009012459
MO
2086S0102X
Surgical Critical Care Physician
2009012459
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053597955
MO
Enumeration date
01/10/2008
Last updated
11/30/2022
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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