Provider Demographics
NPI:1346241569
Name:MELVILLE, DANIEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:MELVILLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 A CENTRE ST
Mailing Address - Street 2:BETH ISRAEL DEACONESS HEALTH CARE - JAMAICA PLAIN
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2071
Mailing Address - Country:US
Mailing Address - Phone:617-522-5464
Mailing Address - Fax:617-524-2966
Practice Address - Street 1:545 A CENTRE ST
Practice Address - Street 2:BETH ISRAEL DEACONESS HEALTH CARE - JAMAICA PLAIN
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2071
Practice Address - Country:US
Practice Address - Phone:617-522-5464
Practice Address - Fax:617-524-2966
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA80675207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine