Provider Demographics
NPI:1902844707
Name:GODAR-MCDAID, MELODY S (DC)
Entity Type:Individual
Prefix:DR
First Name:MELODY
Middle Name:S
Last Name:GODAR-MCDAID
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 KAISER DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1259
Mailing Address - Country:US
Mailing Address - Phone:610-942-4645
Mailing Address - Fax:
Practice Address - Street 1:112 KAISER DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1259
Practice Address - Country:US
Practice Address - Phone:610-942-4645
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-003895-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU01427Medicare UPIN
PAGO552812Medicare ID - Type Unspecified