Provider Demographics
NPI:1164590535
Name:CAMPOPIANO, MELINDA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:MARIE
Last Name:CAMPOPIANO
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 1:5750 CENTRE AVE
Mailing Address - Street 2:SUITE 395
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3721
Mailing Address - Country:US
Mailing Address - Phone:412-665-0515
Mailing Address - Fax:412-665-0458
Practice Address - Street 1:5750 CENTRE AVE
Practice Address - Street 2:SUITE 395
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3721
Practice Address - Country:US
Practice Address - Phone:412-665-0515
Practice Address - Fax:412-665-0458
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417197207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01889800Medicaid
PA01889800Medicaid
PA058552QNVMedicare ID - Type Unspecified