Provider Demographics
NPI:1780751008
Name:MELAAS, DAVID BRUCE (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRUCE
Last Name:MELAAS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:CMR 402 BOX 197
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0197
Mailing Address - Country:US
Mailing Address - Phone:01149661-483-3422
Mailing Address - Fax:
Practice Address - Street 1:CMR 402 BOX 197
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-0197
Practice Address - Country:US
Practice Address - Phone:01149661-483-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical