Individual
THOMAS CHARLES MELILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9115 SW OLESON RD STE 205, PORTLAND, OR 97223-6877
(503) 245-2420
Mailing address
9115 SW OLESON RD STE 205, PORTLAND, OR 97223-6877
(503) 245-2420
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP00334
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228835
—
OR
Enumeration date
08/29/2006
Last updated
01/06/2021
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