Provider Demographics
NPI:1417970674
Name:RICH, MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:RICH
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 1:460 WATERSTONE DR
Mailing Address - Street 2:GI PROCEDURES UNIT
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9078
Mailing Address - Country:US
Mailing Address - Phone:919-595-5969
Mailing Address - Fax:919-595-5943
Practice Address - Street 1:460 WATERSTONE DR
Practice Address - Street 2:GI PROCEDURES UNIT
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9078
Practice Address - Country:US
Practice Address - Phone:919-595-5960
Practice Address - Fax:919-595-5943
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001263207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127N2Medicaid
NC89127N2Medicaid
NC2281189AMedicare ID - Type Unspecified