Individual
STEVEN D MELLUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., FACS
Contact information
Practice address
525 ROUTE 73 S, SUITE 305, MARLTON, NJ 08053-9642
(856) 334-8227
(856) 334-8230
Mailing address
525 ROUTE 73 S, SUITE 305, MARLTON, NJ 08053-9642
(856) 334-8227
(856) 334-8230
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MB07476600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018198
—
NJ
01
—
070943TIA
MEDICARE PTAN
NJ
Enumeration date
08/10/2005
Last updated
05/01/2013
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