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Individual

DR. MENACHEM MELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9822
(215) 748-9717
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6170

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD042497
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012802120016
PA
01
0559166000
KEYSTONE HEALTH PLAN EAST
PA
01
2957202
AETNA HMO
PA
01
30002020
KMHP
PA
01
4292965
AETNA HMO
PA
01
721863
BLUE SHIELD
PA
01
7375879
CIGNA
PA
Enumeration date
11/08/2005
Last updated
05/09/2008
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