Individual
DR. MARK HARRIS MELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3366 NW EXPRESSWAY ST, 650, OKLAHOMA CITY, OK 73112-4462
(405) 713-4430
(405) 713-4429
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 713-4430
(405) 713-4429
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
108354
NY
207RG0100X
Gastroenterology Physician
Primary
14105
OK
207RG0100X
Gastroenterology Physician
36011
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100019460A
—
OK
Enumeration date
12/05/2005
Last updated
04/02/2014
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