Provider Demographics
NPI:1942201306
Name:MELECA, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MELECA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7901 DILEY RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9612
Mailing Address - Country:US
Mailing Address - Phone:614-920-3410
Mailing Address - Fax:614-920-3413
Practice Address - Street 1:7901 DILEY RD
Practice Address - Street 2:SUITE 140
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9612
Practice Address - Country:US
Practice Address - Phone:614-920-3410
Practice Address - Fax:614-920-3413
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35064803207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121004Medicaid
OHME4051184Medicare PIN
OH0121004Medicaid