Provider Demographics
NPI:1700022753
Name:MELANI, KENNETH RUDOLPH (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:RUDOLPH
Last Name:MELANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FIFTH AVE
Mailing Address - Street 2:SUITE 3111
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3099
Mailing Address - Country:US
Mailing Address - Phone:412-544-7245
Mailing Address - Fax:412-544-8240
Practice Address - Street 1:120 FIFTH AVE
Practice Address - Street 2:SUITE 3111
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3099
Practice Address - Country:US
Practice Address - Phone:412-544-7245
Practice Address - Fax:412-544-8240
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023844E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine