Individual
DR. DAVID J MELLISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
490 N BLACK HORSE PIKE, SUITE A, WILLIAMSTOWN, NJ 08094-1404
(856) 728-1111
Mailing address
PO BOX 826, WILLIAMSTOWN, NJ 08094-0826
(856) 728-1111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00409300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0973042-005
CIGNA
NJ
01
—
1066177
AETNA
NJ
01
—
172453
HORIZON BCBS
NJ
05
—
1792300
—
NJ
01
—
222472032
ATLANTICARE
NJ
Enumeration date
01/12/2006
Last updated
08/25/2010
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