Doctor Name: | MELANIE DIANA ELMORE |
NPI Number: | 1013970458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 0010-00705 |
Business Practice Address: | 907 Scotts Ridge Trl Apex, NC - 275026879 |
Business Phone Number: | 9196102765 |
Business Fax Number: | |
Mailing Address: | 907 Scotts Ridge Trl, APEX |
State: | NC |
Postal Code: | 275026879 |
Phone Number: | 9196102765 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2006 |
NPI Last Update Date: | 03/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0010-00705 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |