Provider Demographics
NPI:1265229736
Name:MELOTT, NICHOLAS BRYCE (DO)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:BRYCE
Last Name:MELOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MANNING DRIVE CAMPUS BOX #7070
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7070
Mailing Address - Country:US
Mailing Address - Phone:984-974-6484
Mailing Address - Fax:919-966-7941
Practice Address - Street 1:170 MANNING DRIVE CAMPUS BOX #7070
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7070
Practice Address - Country:US
Practice Address - Phone:984-974-6484
Practice Address - Fax:919-966-7941
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRTL25-0053390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program