Mellus, Timothy James

Mellus, Timothy James is an individual health care provider with primary practice located at 3700 Rivertown Pkwy Sw Space 2112 Rivertown Crossings, Grandville MI 49418-3085. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mellus, Timothy James can be contacted via phone (616) 249-7362.

Contact Information

Primary practice address
3700 Rivertown Pkwy Sw Space 2112 Rivertown Crossings Grandville MI 49418-3085
Fax: (616) 249-8097
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901002398 Michigan

Profile Details

NPI number 1588725964
LBN Legal business name Mellus, Timothy James
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Mar 10th, 2010 - about 14 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 1588725964 NPPES
Michigan Other OP27480 GROUP PTAN

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