Provider Demographics
NPI:1588626956
Name:MELCHERT, ANDREW JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:MELCHERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SKIPWITH RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4442
Mailing Address - Country:US
Mailing Address - Phone:804-282-0403
Mailing Address - Fax:804-273-6803
Practice Address - Street 1:3201 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4442
Practice Address - Country:US
Practice Address - Phone:804-282-0403
Practice Address - Fax:804-273-6803
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT89695Medicare UPIN
VA350000396Medicare ID - Type Unspecified