Individual
DR. DAYTON E DMELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 228A, SAINT LOUIS, MO 63141-8232
(314) 251-4966
(314) 251-4588
Mailing address
621 S NEW BALLAS RD, SUITE 228A, SAINT LOUIS, MO 63141-8232
(314) 251-4966
(314) 251-4588
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37336
CO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
37336
CO
207RP1001X
Pulmonary Disease Physician
Primary
2004030398
MO
207RP1001X
Pulmonary Disease Physician
37336
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699723890
—
MO
05
—
200906402
—
MO
01
—
281763
GROUP HEALTH PLAN
MO
01
—
P01176674
RAILROAD MEDICARE
MO
Enumeration date
05/04/2006
Last updated
03/31/2015
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