Provider Demographics
NPI:1821007584
Name:MELHORN AND MELHORN, D.O., INC.
Entity Type:Organization
Organization Name:MELHORN AND MELHORN, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MELHORN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:804-288-6414
Mailing Address - Street 1:1504 SANTA ROSA RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5109
Mailing Address - Country:US
Mailing Address - Phone:804-288-6414
Mailing Address - Fax:804-288-9022
Practice Address - Street 1:1504 SANTA ROSA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5109
Practice Address - Country:US
Practice Address - Phone:804-288-6414
Practice Address - Fax:804-288-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA204D00000X, 207QS0010X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACL4980OtherRAILROAD MEDICARE
VA049275OtherANTHEM
VA049275OtherANTHEM
VAC02333Medicare ID - Type Unspecified