Provider Demographics
NPI:1902844723
Name:MELAND, JOSEPH M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:MELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2232
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2232
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN186502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN100710OtherUCARE
WI300037790OtherRAILROAD MEDICARE WI
MN22855OtherAMERICA'S PPO
MN667863700Medicaid
IA0539544Medicaid
MN1621680OtherMEDICA
MNP00178945OtherRAILROAD MEDICARE MN
MN0005800OtherPREFERRED ONE
MNHP13959OtherHEALTHPARTNERS
MN81059MEOtherBLUE CROSS
MN298G6MEOtherBLUE CROSS
WI34506500Medicaid
MN22855OtherAMERICA'S PPO
WI34506500Medicaid
MN300003242Medicare PIN
MN667863700Medicaid