Provider Demographics
NPI:1760681902
Name:KANNADAY, MELISSA HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:HARRIS
Last Name:KANNADAY
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 1:125 ALPINE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6385
Mailing Address - Country:US
Mailing Address - Phone:803-779-3548
Mailing Address - Fax:803-779-7055
Practice Address - Street 1:125 ALPINE CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6385
Practice Address - Country:US
Practice Address - Phone:803-779-3548
Practice Address - Fax:803-779-7055
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC297732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry