Individual
DR. MELODY JAN KNEELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
219 BATESVILLE RD, SIMPSONVILLE, SC 29681-4816
(864) 849-9170
(864) 849-9193
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23555
SC
207Q00000X
Family Medicine Physician
Primary
28555
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285550
—
SC
01
—
PO1278181
RAILROAD MEDICARE
SC
01
—
SCL0766067
MEDICARE PIN
SC
01
—
SCL0766084
MEDICARE PIN
SC
01
—
SCL076J577
MEDICARE PIN
SC
Enumeration date
12/13/2006
Last updated
09/17/2021
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