Provider Demographics
NPI:1477536878
Name:MELEGER, ALEC L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEC
Middle Name:L
Last Name:MELEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:781-391-7518
Mailing Address - Fax:781-391-1030
Practice Address - Street 1:125 NASHUA ST
Practice Address - Street 2:SPAULDING REHAB HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1198
Practice Address - Country:US
Practice Address - Phone:781-391-7518
Practice Address - Fax:781-391-1030
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA155429208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ23572OtherBCBS MA
MA155429OtherTUFTS HEALTH PLAN
MA0139173Medicaid
MA0139173Medicaid
MAJ23572OtherBCBS MA