Provider Demographics
NPI:1619049194
Name:STEPHENS, MELISSA FALK (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:FALK
Last Name:STEPHENS
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 1:701 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-1655
Mailing Address - Country:US
Mailing Address - Phone:717-361-0390
Mailing Address - Fax:
Practice Address - Street 1:4748 E HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-9004
Practice Address - Country:US
Practice Address - Phone:717-367-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051439L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine