Melicosta, Michelle Elaine
Melicosta, Michelle Elaine is an individual health care provider with primary practice located at 707 N Broadway Kennedy Krieger Institute, Baltimore MD 21205-1832. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Melicosta, Michelle Elaine can be contacted via phone (443) 923-9446.Contact Information
Primary practice address
707 N Broadway Kennedy Krieger Institute
Baltimore MD 21205-1832
Phone: (443) 923-9446
Fax: (443) 923-9445
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 153384 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | D0078581 | Maryland |
Profile Details
| NPI number | 1558320010 |
|---|---|
| LBN Legal business name | Melicosta, Michelle Elaine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Mar 17th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558320010 | NPPES |
| Arizona | MEDICAID | 970774 | |
| Arizona | MEDICAID | 79426778 | |
| Arizona | MEDICAID | 541054100 |
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