Provider Demographics
NPI:1578532818
Name:MELCHER, ARCHIE (MD)
Entity Type:Individual
Prefix:
First Name:ARCHIE
Middle Name:
Last Name:MELCHER
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 1:3800 HOUMA BLVD
Mailing Address - Street 2:STE. 205
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4182
Mailing Address - Country:US
Mailing Address - Phone:405-885-7337
Mailing Address - Fax:504-456-5172
Practice Address - Street 1:3800 HOUMA BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4182
Practice Address - Country:US
Practice Address - Phone:405-885-7337
Practice Address - Fax:504-456-5172
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0199292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1931390Medicaid
LAF21327Medicare UPIN
LA5N91257053Medicare PIN