Individual
CARL MICHAEL MELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1555 NORTHWAY DRIVE, SUITE 200, ST CLOUD, MN 56303-4913
(320) 240-3157
(320) 240-3143
Mailing address
1555 NORTHWAY DRIVE, SUITE 200, ST CLOUD, MN 56303-4913
(320) 240-3157
(320) 240-3143
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23352
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104099
MEDICA HEALTH PLANS
—
01
—
47A49ME
BLUE CROSS BLUE SHIELD
—
01
—
600863
ARAZ GRP AMERICA'S PPO
—
01
—
68793600
MEDICAL ASSISTANCE
—
01
—
889003
PREFERRED ONE
—
01
—
938031
FIRST HEALTH PLAN
—
01
—
HP17772
HEALTH PARTNERS
—
Enumeration date
11/07/2005
Last updated
05/21/2013
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