Provider Demographics
NPI:1821491531
Name:CEME, MELCHIOR R (DC)
Entity Type:Individual
Prefix:DR
First Name:MELCHIOR
Middle Name:R
Last Name:CEME
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 1:1594 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2121
Mailing Address - Country:US
Mailing Address - Phone:617-870-4577
Mailing Address - Fax:508-535-5111
Practice Address - Street 1:1594 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2121
Practice Address - Country:US
Practice Address - Phone:617-870-4577
Practice Address - Fax:508-535-5111
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3471111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation