Provider Demographics
NPI:1114151750
Name:RATLIFF, MELISSA H (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:H
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-5080
Mailing Address - Fax:704-316-5085
Practice Address - Street 1:5815 BLAKENEY PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5731
Practice Address - Country:US
Practice Address - Phone:704-316-5080
Practice Address - Fax:704-316-5085
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC156955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC156955OtherRESIDENT TRAINING LICENSE
NC5920809Medicaid
NC5920809Medicaid
NCNC7634AMedicare PIN