| Melissa J Mcculley O D P C | |
| 
					567 32nd Ave E, West Fargo, ND 58078-8480  | |
| (701) 373-2020 | |
| (701) 373-0021 | 
| Full Name | Melissa J Mcculley O D P C | 
|---|---|
| Type | Facility | 
| Speciality | Optometrist | 
| Location | 567 32nd Ave E, West Fargo, North Dakota | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497871214 | NPI | - | NPPES | 
| 06711001 | Other | ND | BLUE SHIELD GROUP NUMBER | 
| 88G74MC | Other | MN | BLUE SHIELD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | ND597 (North Dakota) | Primary | 
| Provider Name | Melissa J Mcculley | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1912023714 PECOS PAC ID: 7012965023 Enrollment ID: I20051223000152  | 
| Provider Name | Tracie Malsom | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1720038441 PECOS PAC ID: 8628085750 Enrollment ID: I20131126001931  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Melissa J Mcculley O D P C 567 32nd Ave E, West Fargo, ND 58078-8480 Ph: (701) 373-2020  | Melissa J Mcculley O D P C 567 32nd Ave E, West Fargo, ND 58078-8480 Ph: (701) 373-2020  | 
John Gregory Dye, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 1207 Prairie Pkwy, West Fargo, ND 58078 Phone: 701-282-2020 Fax: 701-282-0230  | |
Brooke Marie Messer, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 354 23rd Ave E, West Fargo, ND 58078 Phone: 701-566-5390 Fax: 605-371-7199  | |
Nicholas Christian Risbrudt, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 354 23rd Ave E, West Fargo, ND 58078 Phone: 701-566-5390 Fax: 605-371-7199  | |
Madison Rae Bosh,  Optometrist Medicare: Medicare Enrolled Practice Location: 354 23rd Ave E, West Fargo, ND 58078 Phone: 701-566-5390 Fax: 605-371-7199  | |
Anna Joy Miller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 750 23rd Ave E, West Fargo, ND 58078 Phone: 701-281-2237  | |
Christian Jalen Pratt, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 505 32nd Ave E Ste B, West Fargo, ND 58078 Phone: 701-566-5390 Fax: 701-539-7199  |