Provider Demographics
NPI:1861403222
Name:MELEK, STEVE SCOTT
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:SCOTT
Last Name:MELEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1350
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-1350
Mailing Address - Country:US
Mailing Address - Phone:304-752-3338
Mailing Address - Fax:304-752-0194
Practice Address - Street 1:RT 10
Practice Address - Street 2:TRIANGLE ADDITION PROFESSIONAL BLDG
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601
Practice Address - Country:US
Practice Address - Phone:304-752-3338
Practice Address - Fax:304-752-0194
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV269213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099710000Medicaid
WV0723783Medicare PIN
WV0099710000Medicaid
WV4696850001Medicare NSC