Provider Demographics
NPI:1033313911
Name:ALBERT, MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1000 MON HEALTH MEDICAL PARK DR STE 1202
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1143
Mailing Address - Country:US
Mailing Address - Phone:304-599-1975
Mailing Address - Fax:304-599-2705
Practice Address - Street 1:1000 MON HEALTH MEDICAL PARK DR STE 1202
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1143
Practice Address - Country:US
Practice Address - Phone:304-599-1975
Practice Address - Fax:304-599-2705
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431485208000000X, 2084P0800X
WV224432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101940817-0003Medicaid
WV3810009165Medicaid
PA101940817-0002Medicaid
WVCA7030OtherRAILROAD MEDICARE GROUP #
WVP00610954OtherRAILROAD MEDICARE
WVAL6035851Medicare PIN
WV3810009165Medicaid