Individual
TODD D MELLISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4 ELLIOT WAY, STE 102, MANCHESTER, NH 03103-3551
(603) 626-5900
(603) 625-2180
Mailing address
6 TSIENNETO RD, STE 300, DERRY, NH 03038-1584
(603) 216-0400
(603) 216-3800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11330
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01YP03381NH03
ANTHEM NH
—
Enumeration date
05/09/2006
Last updated
02/16/2019
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