Provider Demographics
NPI:1629342910
Name:GUNTHER, MELISSA RAE (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RAE
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 MOUNT HERMON RD STE A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5159
Mailing Address - Country:US
Mailing Address - Phone:410-749-4400
Mailing Address - Fax:410-749-0847
Practice Address - Street 1:951 MOUNT HERMON RD STE A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5159
Practice Address - Country:US
Practice Address - Phone:410-749-4400
Practice Address - Fax:410-749-0847
Is Sole Proprietor?:No
Enumeration Date:2012-03-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMG2582256OtherDEA