Provider Demographics
NPI:1801839949
Name:MELNICK, SCOTT A (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:MELNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4070 BUTLER PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1556
Mailing Address - Country:US
Mailing Address - Phone:610-825-5741
Mailing Address - Fax:610-825-1885
Practice Address - Street 1:4070 BUTLER PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1556
Practice Address - Country:US
Practice Address - Phone:610-825-5741
Practice Address - Fax:610-825-1885
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD016704E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080128578OtherRRM
PA0047228000OtherIBC - PC/KHPE
PA0075833002OtherAMERICHOICE (UHC MA PLAN)
PA0007583300001Medicaid
PA1027899OtherKEYSTONE MERCY
PA1095934OtherCIGNA HMO/PPO
PA11044928OtherMULTIPLAN
PA4101141OtherAETNA PPO
PA0047228000OtherAMERIHEALTH/INTERCOUNTY
PA095332OtherHIGHMARK BLUE SHIELD
PA11340253OtherCAQH ID#
PA2124021OtherALLIANCE/OPT CHC (MAMSI)
PAP506094OtherOXFORD
PA0002063OtherAETNA HMO
PA350777OtherPHCS
PA36452-MD016704EOtherHEALTH PARTNERS
PA11044928OtherMULTIPLAN
PA350777OtherPHCS