Melby Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DO36425 Issued in SC

Legal business name

MELBY MEDICAL LLC

Practice address

1148 Wessington Manor LN
Fort Mill, SC 29715-7806

Phone

(757) 377-7137

NPI assigned

Nov 1, 2016

Organization subpart

No

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

Authorized official

Name

Derek A Melby, DO

Title

Sole MBR

Phone

(757) 377-7137

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1083166599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 WESSINGTON MANOR LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157806",
            "telephone_number": "757-377-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 WESSINGTON MANOR LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157806",
            "telephone_number": "757-377-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELBY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "MELBY",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "757-377-7137",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "DO36425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.