Provider Demographics
NPI:1730426644
Name:DINNER, MELVYN IVAN (MD)
Entity type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:IVAN
Last Name:DINNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 MARSEILLE DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1280
Mailing Address - Country:US
Mailing Address - Phone:561-624-9030
Mailing Address - Fax:561-595-0192
Practice Address - Street 1:2523 MARSEILLE DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-1280
Practice Address - Country:US
Practice Address - Phone:561-624-9030
Practice Address - Fax:561-595-0192
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94656174400000X
OH35.040170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist