Provider Demographics
NPI:1568477941
Name:MELMED, ALLAN STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:STANLEY
Last Name:MELMED
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 1:7659 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2520
Mailing Address - Country:US
Mailing Address - Phone:703-356-5888
Mailing Address - Fax:
Practice Address - Street 1:7659 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2520
Practice Address - Country:US
Practice Address - Phone:703-356-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010264882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC62158Medicare UPIN
DC409797Medicare ID - Type Unspecified