Provider Demographics
NPI:1912902693
Name:MELGARY, DAVID MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:MELGARY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1520
Mailing Address - Country:US
Mailing Address - Phone:740-676-4717
Mailing Address - Fax:740-676-4695
Practice Address - Street 1:3233 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1520
Practice Address - Country:US
Practice Address - Phone:740-676-4717
Practice Address - Fax:740-676-4695
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3515 T782152W00000X
WVMM0091518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410002650OtherRAILROAD MEDICARE
OH0619307Medicaid
1310559OtherUMWA
OH0312070001OtherMEDICARE NSC
OH0312070001OtherMEDICARE NSC
1310559OtherUMWA