Provider Demographics
NPI:1588665418
Name:ZELLARS, MELINDA RENEE (DPM)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:RENEE
Last Name:ZELLARS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:20528 BOLAND FARM RD STE 202
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4038
Practice Address - Country:US
Practice Address - Phone:301-232-9000
Practice Address - Fax:301-232-5251
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO1000055213EP1101X
MD01367213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC492128OtherMEDICARE
DC49380001OtherCAREFIRST
DCBK640000OtherCAREFIRST
DC039223700OtherMEDICAL ASSISTANCE
MDBK640000OtherCAREFIRST
MD009436600OtherMEDICAL ASSISTANCE
MDP00178082OtherRAILROAD MEDICARE
MD135514OtherMEDICARE
MD49380001OtherCAREFIRST