Bullock, Melvin Dana
Bullock, Melvin Dana is an individual health care provider with primary practice located at 11685 Alpharetta Hwy Suite 320, Roswell GA 30076-4913. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Bullock, Melvin Dana can be contacted via phone (770) 442-5882.Contact Information
Primary practice address
11685 Alpharetta Hwy Suite 320
Roswell GA 30076-4913
Phone: (770) 442-5882
Fax: (470) 514-3759
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 063638 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME105404 | Florida |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 63638 | Georgia |
Profile Details
| NPI number | 1093869786 |
|---|---|
| LBN Legal business name | Bullock, Melvin Dana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Mar 4th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093869786 | NPPES |
| Florida | Other | 146KW | BC/BS |
| Florida | Other | P00782776 | BC/BS |
| Florida | MEDICAID | 003101130D | BC/BS |
| Florida | MEDICAID | 003101130E | BC/BS |
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