Individual
JOHN JORDAN MELCHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE B350, GREENVILLE, SC 29615-6337
(864) 454-4500
(864) 454-4505
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01080191A
IN
2084N0400X
Neurology Physician
Primary
89196
SC
2084N0600X
Clinical Neurophysiology Physician
89196
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972922391
NPI NUMBER
—
05
—
PENDING
—
SC
Enumeration date
04/14/2014
Last updated
12/17/2024
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