Melchor F Vidal, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

13443 Issued in WV

Practice address

27545 Daniel Boone Prkwy
Racine, WV 25165

Phone

(304) 837-8637

NPI assigned

Sep 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Melchor F Vidal MD PLLC

  • Family Medicine Physician
  • Racine, WV
  • NPI 1073714127
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063515054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4535",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644535",
            "telephone_number": "304-837-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27545 DANIEL BOONE PRKWY",
            "city": "RACINE",
            "state": "WV",
            "postal_code": "25165",
            "telephone_number": "304-837-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "MELCHOR",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WV",
            "license": "13443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049855001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Cooper
• Kerry D Harless
• Rhonda Hayes
• Melchor F Vidal MD PLLC
• Taylor Viars

• Geriatric Medicine (Family Medicine) Physician in Racine, WV
• Providers in Racine, WV by specialty
• Geriatric Medicine (Family Medicine) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.