Provider Demographics
NPI:1235219379
Name:THIEL, MELISSA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JOY
Last Name:THIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 S WHITING ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-7100
Mailing Address - Country:US
Mailing Address - Phone:703-823-4770
Mailing Address - Fax:703-823-5873
Practice Address - Street 1:205 S WHITING ST
Practice Address - Street 2:SUITE 303
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7100
Practice Address - Country:US
Practice Address - Phone:703-823-4770
Practice Address - Fax:703-823-5873
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042659207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology