Provider Demographics
NPI:1205371135
Name:MELILLO, GIOVANNI (MD)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:
Last Name:MELILLO
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 1:2554 BEAR DEN RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5230
Mailing Address - Country:US
Mailing Address - Phone:301-639-2190
Mailing Address - Fax:
Practice Address - Street 1:2554 BEAR DEN RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5230
Practice Address - Country:US
Practice Address - Phone:301-639-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056750207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology