Organization Active NPI

David a Mellul DPM

  • Podiatrist
  • Cherry Hill, NJ
National Provider Identifier
1255352209
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD1488 Issued in NJ
Legal business name
DAVID A MELLUL DPM
Practice address
200 Kings Hwy S
Cherry Hill, NJ 08034-2506
Phone
(856) 429-9009
Fax
(856) 429-8400
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
David A Mellul, D.P.M.
Title
Sole Proprietor
Phone
(856) 429-9009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X MD1488 NJ Primary

Addresses

Primary practice location

200 Kings Hwy S
Cherry Hill, NJ 08034-2506

Mailing address

200 Kings Hwy S
Cherry Hill, NJ 08034-2506
Phone (856) 429-9009

Other identifiers 1

IdentifierTypeStateIssuer
209900401MedicaidNJ

National Provider Directory

National Provider Directory

Locations

200 Kings Hwy S
Cherry Hill, NJ 08034
Phone (609) 429-9009

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1255352209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 KINGS HWY S",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342506",
            "telephone_number": "856-429-9009",
            "fax_number": "856-429-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KINGS HWY S",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342506",
            "telephone_number": "856-429-9009",
            "fax_number": "856-429-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A MELLUL DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "MELLUL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "856-429-9009",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD1488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209900401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.