Provider Demographics
NPI:1659393031
Name:EIRICH, MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:EIRICH
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 1:1021 N STATE ROAD 7
Mailing Address - Street 2:MEDEXPRESS URGENT CARE
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5117
Mailing Address - Country:US
Mailing Address - Phone:561-333-9331
Mailing Address - Fax:
Practice Address - Street 1:1021 N STATE ROAD 7
Practice Address - Street 2:MEDEXPRESS URGENT CARE
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5117
Practice Address - Country:US
Practice Address - Phone:561-333-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2022207P00000X
FLME101416207PE0004X, 207P00000X
NY203981207P00000X
KY52240207P00000X
ARE-12011207P00000X
TN58757207P00000X
LA312131207P00000X
CAG162220207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01720841Medicaid
NY14300CMedicare PIN
NYG18296Medicare UPIN