Provider Demographics
NPI:1942921390
Name:ROBINSON, MELISSA MARIA
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MARIA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:MARIA
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEDICAL TRICHOLOGIST
Mailing Address - Street 1:1214 EUTAW PL STE 2
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3605
Mailing Address - Country:US
Mailing Address - Phone:410-446-2791
Mailing Address - Fax:
Practice Address - Street 1:1214 EUTAW PL STE 2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3605
Practice Address - Country:US
Practice Address - Phone:410-446-2791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management