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Contact Information

GARY A MELLICK, DO
2525 W UNIVERSITY AVE STE 502
MUNCIE, IN47303-3409
 Phone: 765-751-2600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
 

Pain Medicine

2084P2900X 86 Physician/Neuropsychiatry
 

Sleep Medicine

2084S0012X 86 Physician/Neuropsychiatry
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for GARY A MELLICK · (Male)

NPI Number 1780641506
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/26/2006
Last updated 01/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • AL License # DO1117
  • GA License # 055142
  • IN License # 02006613A
  • OH License # 34004503
  • OH Medicaid 078521
Hospital affiliation(s)
  • INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL - (Acute Care)
    2401 UNIVERSITY AVE
    MUNCIE, IN 47303
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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