Provider Demographics
NPI:1689994105
Name:SAWYER FALCON, MELISSA LA (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LA
Last Name:SAWYER FALCON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:LA
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2500 MARYLAND RD
Mailing Address - Street 2:STE 400
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1225
Mailing Address - Country:US
Mailing Address - Phone:215-762-5030
Mailing Address - Fax:
Practice Address - Street 1:2300 COMPUTER RD STE H39
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1740
Practice Address - Country:US
Practice Address - Phone:215-657-5200
Practice Address - Fax:215-657-8083
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016528207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102858721Medicaid