Individual
TIA M MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3941
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-067656
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221306
UNISON
OH
01
—
000000509178
ANTHEM
OH
05
—
2054897
—
OH
01
—
363833
WELLCARE
OH
01
—
5059547
AETNA
OH
01
—
738078
BUCKEYE
OH
01
—
P00225578
RAILROAD MEDICARE
OH
Enumeration date
07/08/2006
Last updated
12/28/2020
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