| Dr David Myatt Melniczek, MD | |
|
777 S State Highway 49 Ste 1&2, Jackson, CA 95642-2685 | |
| (209) 256-8200 | |
| (209) 256-8204 |
| Full Name | Dr David Myatt Melniczek |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 27 Years |
| Location | 777 S State Highway 49 Ste 1&2, Jackson, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275575664 | NPI | - | NPPES |
| A92447 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | A92447 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mark Twain Medical Center | San andreas, CA | Hospital |
| Adventist Health Sonora | Sonora, CA | Hospital |
| St Joseph's Medical Center Of Stockton | Stockton, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mark Twain Medical Center | 8820073711 | 17 |
| Entity Name | Mark Twain Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508968819 PECOS PAC ID: 8820073711 Enrollment ID: O20061006000227 |
| Entity Name | David M Melniczek Md Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053818815 PECOS PAC ID: 5193078772 Enrollment ID: O20181029001820 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Myatt Melniczek, MD 777 S State Highway 49 Ste 1&2, Jackson, CA 95642-2685 Ph: (209) 256-8200 | Dr David Myatt Melniczek, MD 777 S State Highway 49 Ste 1&2, Jackson, CA 95642-2685 Ph: (209) 256-8200 |
Dr. Adam Clementi Delgado, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 Mission Blvd Ste 2800, Jackson, CA 95642 Phone: 209-257-7615 Fax: 209-257-5856 | |
Dr. John Holbert Ellyson, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 340 Lowe St, Jackson, CA 95642 Phone: 209-223-2474 | |
Dr. Mohammed Nasiruddin Siddiqui, MD FACS Surgery Medicare: Not Enrolled in Medicare Practice Location: 609 New York Ranch Rd, Jackson, CA 95642 Phone: 209-257-0301 Fax: 209-257-0302 |