Provider Demographics
NPI:1609829936
Name:MELVIN, JOSEPH J (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:MELVIN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:160 EAST ERIE AVE
Mailing Address - Street 2:ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1095
Mailing Address - Country:US
Mailing Address - Phone:215-427-5470
Mailing Address - Fax:215-427-4393
Practice Address - Street 1:160 E ERIE AVE
Practice Address - Street 2:ST CHRISTOPHER'S HOSPITAL FOR CHILDREN NEUROLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1011
Practice Address - Country:US
Practice Address - Phone:215-427-5470
Practice Address - Fax:215-427-4393
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-09-07
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Provider Licenses
StateLicense IDTaxonomies
PAOS008444L2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013624130003Medicaid
PA0013624130003Medicaid