Provider Demographics
NPI:1407721665
Name:MELTON, FAITH A S (MS)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:A S
Last Name:MELTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 DULUTH HWY STE F
Mailing Address - Street 2:1270
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5143
Mailing Address - Country:US
Mailing Address - Phone:678-453-8143
Mailing Address - Fax:
Practice Address - Street 1:67 DAVIS MILL CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4634
Practice Address - Country:US
Practice Address - Phone:678-453-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier