Provider Demographics
NPI:1598499055
Name:MELVIN INVESTMENT GROUP, LLC
Entity Type:Organization
Organization Name:MELVIN INVESTMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/NURSE PRACTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONISHA
Authorized Official - Middle Name:JEANE
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-669-7496
Mailing Address - Street 1:10421 MOTOR CITY DR STE 341334
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-9996
Mailing Address - Country:US
Mailing Address - Phone:240-669-7496
Mailing Address - Fax:
Practice Address - Street 1:10400 CONNECTICUT AVE STE 206
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3941
Practice Address - Country:US
Practice Address - Phone:240-669-7496
Practice Address - Fax:301-321-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty