Provider Demographics
NPI:1659552958
Name:STEVE SCOTT MELEK
Entity Type:Organization
Organization Name:STEVE SCOTT MELEK
Other - Org Name:WILLIAMSON FOOT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MELEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-752-3338
Mailing Address - Street 1:PO BOX 1350
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-1350
Mailing Address - Country:US
Mailing Address - Phone:304-752-3338
Mailing Address - Fax:304-752-0194
Practice Address - Street 1:17 MAIN AVE
Practice Address - Street 2:PROFESSIONAL BUILDING
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3332
Practice Address - Country:US
Practice Address - Phone:304-752-3338
Practice Address - Fax:304-752-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV269213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099710000Medicaid
WV0099710000Medicaid
WVU34655Medicare UPIN
WV9311301Medicare PIN