Provider Demographics
NPI:1033393905
Name:BIRCH, MELANIE L (LAC, MAC)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:L
Last Name:BIRCH
Suffix:
Gender:F
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 SAINT JAMES RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2251
Mailing Address - Country:US
Mailing Address - Phone:443-286-0927
Mailing Address - Fax:
Practice Address - Street 1:3520 SAINT JAMES RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2251
Practice Address - Country:US
Practice Address - Phone:443-286-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00903171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist