Provider Demographics
NPI:1861483463
Name:ZALE, MELISSA MACCOY (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MACCOY
Last Name:ZALE
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 1:1802 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3420
Mailing Address - Country:US
Mailing Address - Phone:302-655-5576
Mailing Address - Fax:302-655-5949
Practice Address - Street 1:908 E 16TH ST STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-5145
Practice Address - Country:US
Practice Address - Phone:302-575-1414
Practice Address - Fax:302-225-4526
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94394207Q00000X
DEC1-0008976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine