Individual
DR. RICHARD G DMELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1312 PROFESSIONAL BLVD, SUITE 200, EVANSVILLE, IN 47714-8007
(812) 491-6419
(812) 491-6465
Mailing address
1312 PROFESSIONAL BLVD, SUITE 200, EVANSVILLE, IN 47714-8007
(812) 491-6419
(812) 491-6465
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01047609
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200398050
—
IN
01
—
3900088571
RAILROAD MEDICARE
IN
05
—
64063555
—
KY
01
—
7928408
AETNA
IN
01
—
86207
COVENTRY
KY
Enumeration date
08/01/2005
Last updated
08/27/2013
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