Provider Demographics
NPI:1508893827
Name:MILLER, MELANIE A (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:MILLER
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:PO BOX 1477
Mailing Address - Street 2:
Mailing Address - City:OAK BLUFFS
Mailing Address - State:MA
Mailing Address - Zip Code:02557-1477
Mailing Address - Country:US
Mailing Address - Phone:508-684-4500
Mailing Address - Fax:508-684-4502
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557-1406
Practice Address - Country:US
Practice Address - Phone:505-684-4500
Practice Address - Fax:508-684-4502
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204593208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics