Basic Information
| Provider Information | |||||||||
| NPI: | 1023225448 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALEC | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 714328 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432714328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402791500 | ||||||||
| FaxNumber: | 4402791501 | ||||||||
| Practice Location | |||||||||
| Address1: | 510 FIFTH AVENUE | ||||||||
| Address2: | |||||||||
| City: | CHARDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402791500 | ||||||||
| FaxNumber: | 4402791501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 06/16/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 57.011795 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 35-092422 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.