Melvin T Vidal MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19970 Issued in WV

Legal business name

MELVIN T VIDAL MD PLLC

Practice address

1313 Quarrier St
Charleston, WV 25301-6002

Phone

(304) 720-2060

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Melvin T Vidal, MD

Title

Owner

Phone

(304) 720-2060

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1598984841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1055",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255601055",
            "telephone_number": "304-720-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 QUARRIER ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253016002",
            "telephone_number": "304-720-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELVIN T VIDAL MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "VIDAL",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-720-2060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "19970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010643",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110217977",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "DB2539",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001706078",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty Mehta
• Nimish Mehta, MD
• Etsepatos Mekonnen
• Margaret Leigh Meldrum, M.D.
• Paul Francis Melton, RPH
• Sobia Memon, MD
• Valentina Menchero-Machado, DO
• Jonathan Mendez
• Berhan Menebo
• Cristina Pauline Menking-Hoggatt, CNM

• All providers in Charleston, WV
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.