Provider Demographics
NPI:1821396011
Name:MELANDER, MICHAEL THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:MELANDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ARTHUR WELCH DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-6200
Mailing Address - Country:US
Mailing Address - Phone:978-502-9913
Mailing Address - Fax:
Practice Address - Street 1:13 POND ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3915
Practice Address - Country:US
Practice Address - Phone:978-406-9700
Practice Address - Fax:617-249-0662
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor