Provider Demographics
NPI:1679898084
Name:PE, MELISSA (DO)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SPRINGBENNY
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1311
Mailing Address - Country:US
Mailing Address - Phone:327-545-5377
Mailing Address - Fax:
Practice Address - Street 1:4735 OGLETOWN STANTON RD STE 1116
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2089
Practice Address - Country:US
Practice Address - Phone:302-386-8612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0010439208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics