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Individual

MICHAEL GEORGE MELKONIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2104 RANDOLPH RD, CHARLOTTE, NC 28207-1522
(704) 377-3900
(704) 377-1244
Mailing address
2104 RANDOLPH ROAD, CHARLOTTE, NC 28207-1522
(704) 377-3900
(704) 377-1244

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
300100744
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
129GP
BLUE CROSS & BLUE SHIELD
NC
05
89129GP
NC
Enumeration date
09/20/2006
Last updated
10/25/2020
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