Individual
STEVEN D MELLUL
Active
Individual
STEVEN D MELLUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., FACS
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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