Provider Demographics
NPI:1275941163
Name:MELLER, STEPHANIE ONG (M D)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ONG
Last Name:MELLER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6357 OXON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-2214
Mailing Address - Country:US
Mailing Address - Phone:301-839-2700
Mailing Address - Fax:301-839-1354
Practice Address - Street 1:6357 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2214
Practice Address - Country:US
Practice Address - Phone:301-839-2700
Practice Address - Fax:301-839-1354
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0085545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program