Provider Demographics
NPI:1982714960
Name:MELINE, DANIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:MELINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3020 E CAMELBACK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5095
Mailing Address - Country:US
Mailing Address - Phone:602-264-9100
Mailing Address - Fax:602-264-9101
Practice Address - Street 1:9767 N 91ST ST
Practice Address - Street 2:#100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5086
Practice Address - Country:US
Practice Address - Phone:480-860-1990
Practice Address - Fax:480-860-1887
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21078207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ116518Medicaid
AZ317047OtherGROUP MEDICAID NUMBER
AZAZ0398120OtherBCBS
AZ120390OtherGROUP MEDICARE NUMBER
AZ116518Medicaid
AZZMD21078Medicare PIN
AZAZ0398120OtherBCBS