Individual
DR. DEREK MELLOTT
Active
Individual
DR. DEREK MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3951
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226430
ANTHEM BC/BS
OH
05
—
0691381
—
OH
01
—
2201047
UNITED HEALTH CARE
OH
01
—
341605571028
CARESOURCE
OH
01
—
410035075
RAILROAD MEDICARE
OH
Enumeration date
07/20/2006
Last updated
12/28/2007
Update your record
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