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Individual

DR. KEVIN F D'MELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-3150
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA10760900
NJ
207R00000X
Internal Medicine Physician
MD448708
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT197420
PA MEDICAL LICENSE NUMBER
PA
Enumeration date
07/22/2010
Last updated
02/25/2020
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