Individual
GARY A. MELLICK
Active
Individual
GARY A. MELLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
055142
GA
174400000X
Specialist
34004503
OH
2084N0400X
Neurology Physician
Primary
02006613A
IN
2084N0400X
Neurology Physician
DO1117
AL
2084N0600X
Clinical Neurophysiology Physician
DO1117
AL
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
DO1117
AL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
DO1117
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078521
—
OH
Enumeration date
04/26/2006
Last updated
01/14/2022
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