George Mellos MD PLLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

4301050595 Issued in MI

Legal business name

GEORGE MELLOS MD PLLC

Practice address

43200 Dequindre Rd
Ste 104
Sterling Heights, MI 48314-1707

Phone

(586) 799-4350

Fax

(586) 799-4279

NPI assigned

Aug 19, 2016

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George E Mellos, MDNPI 1295824647

Title

Owner

Phone

(248) 949-8886

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Evan Mellos, M.D.

  • Psychiatry Physician
  • Northville, MI
  • NPI 1295824647
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1619422649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28890 VILLAGE LN",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343154",
            "telephone_number": "248-949-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43200 DEQUINDRE RD",
            "address_2": "STE 104",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141707",
            "telephone_number": "586-799-4350",
            "fax_number": "586-799-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE MELLOS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "MELLOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-949-8886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301050595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Gennero, D.C.
• Rebecca Ruth Gennero, D.C.
• James Gentile
• Mark A Gentner, D.D.S.
• Justin Gentry
• Diane L. George, D.O.
• Lashondra George
• Ryan Patrick George
• Edmon Georges, O.D.
• Georgetown Dermatologists, P.C.

• Child & Adolescent Psychiatry Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.