Provider Demographics
NPI:1780669606
Name:MCCALL, MELISSA A (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:MCCALL
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 1:1670 CIRCLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-7711
Mailing Address - Country:US
Mailing Address - Phone:907-301-5948
Mailing Address - Fax:
Practice Address - Street 1:3300 PROVIDENCE DR STE 207
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4620
Practice Address - Country:US
Practice Address - Phone:907-561-0007
Practice Address - Fax:907-563-9140
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5759207L00000X
CAA749070207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A749070Medicare ID - Type Unspecified
CAH87554Medicare UPIN