Provider Demographics
NPI:1962668046
Name:MELETH, ANNAL DHANANJAYAN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:ANNAL
Middle Name:DHANANJAYAN
Last Name:MELETH
Suffix:
Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:895 CANTON RD NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8934
Mailing Address - Country:US
Mailing Address - Phone:770-427-8111
Mailing Address - Fax:
Practice Address - Street 1:895 CANTON RD NE
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8934
Practice Address - Country:US
Practice Address - Phone:770-427-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC144107207W00000X
DCMD038232207W00000X
GA069515207W00000X
TXN9470207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology