Mellema, James P

Mellema, James P is an individual health care provider with primary practice located at 6440 Nicollet Ave So , Richfield MN 55423-1697. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mellema, James P can be contacted via phone (612) 861-1622.

Contact Information

Primary practice address
6440 Nicollet Ave So Richfield MN 55423-1697
Phone: (612) 861-1622
Fax: (612) 861-2307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26730 Minnesota

Profile Details

NPI number 1316927791
LBN Legal business name Mellema, James P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Feb 6th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316927791 NPPES
Minnesota MEDICAID 741365300

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