Provider Demographics
NPI:1114638988
Name:MELCHERS, RYAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:MELCHERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 VIRGINIA BEACH BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3114
Mailing Address - Country:US
Mailing Address - Phone:757-963-1488
Mailing Address - Fax:
Practice Address - Street 1:4421 VIRGINIA BEACH BLVD STE 112
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3114
Practice Address - Country:US
Practice Address - Phone:757-963-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant