Provider Demographics
NPI:1710152723
Name:PIDGEON, MELISA SWEET (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISA
Middle Name:SWEET
Last Name:PIDGEON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:PIDGEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:5842 FAYETTEVILLE RD STE 118
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6294
Mailing Address - Country:US
Mailing Address - Phone:919-410-8840
Mailing Address - Fax:866-598-8851
Practice Address - Street 1:5842 FAYETTEVILLE RD STE 118
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6294
Practice Address - Country:US
Practice Address - Phone:919-410-8840
Practice Address - Fax:866-598-8851
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist