Provider Demographics
NPI:1720029846
Name:HORNER, MELISSA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:HORNER
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:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1236
Mailing Address - Country:US
Mailing Address - Phone:412-937-9640
Mailing Address - Fax:412-937-8639
Practice Address - Street 1:324 RODI RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3318
Practice Address - Country:US
Practice Address - Phone:412-731-7500
Practice Address - Fax:412-731-4794
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019112310003Medicaid
PA1409264OtherHIGHMARK BCBS
PA0019112310003Medicaid
PA1409264OtherHIGHMARK BCBS