Individual
DR. BRENT CAMERON MELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1040 DELAWARE AVE, MARION, OH 43302-6416
(740) 383-7960
(740) 382-6469
Mailing address
1040 DELAWARE AVENUE, COLUMBUS, OH 43302-6453
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34011391
OH
207X00000X
Orthopaedic Surgery Physician
5101017860
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104749
—
OH
05
—
9148
—
MI
Enumeration date
02/15/2009
Last updated
12/21/2021
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