Provider Demographics
NPI:1629851092
Name:MELODY MEDICAL GROUP P.C.
Entity Type:Organization
Organization Name:MELODY MEDICAL GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SKOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-471-3898
Mailing Address - Street 1:1614 ALDERBROOK RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-4108
Mailing Address - Country:US
Mailing Address - Phone:404-471-3898
Mailing Address - Fax:
Practice Address - Street 1:1123 CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1207
Practice Address - Country:US
Practice Address - Phone:404-471-3898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty