Provider Demographics
NPI:1326369703
Name:SUM, MELISSA W (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:W
Last Name:SUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:PH 8-864
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:212-305-6486
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:PH 8-864
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-6472
Practice Address - Fax:212-305-6486
Is Sole Proprietor?:No
Enumeration Date:2010-06-19
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY274990207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism