Provider Demographics
NPI:1558933911
Name:MELISSA DUNCANSON MD INC
Entity Type:Organization
Organization Name:MELISSA DUNCANSON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DUNCANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-867-0669
Mailing Address - Street 1:136 N SAN MATEO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2779
Mailing Address - Country:US
Mailing Address - Phone:650-344-1114
Mailing Address - Fax:
Practice Address - Street 1:136 N SAN MATEO DR STE 101
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2779
Practice Address - Country:US
Practice Address - Phone:650-344-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty