Provider Demographics
NPI:1972508182
Name:NASSIF-PLA, MELISSA (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:NASSIF-PLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-425-2212
Mailing Address - Fax:330-425-2779
Practice Address - Street 1:8819 COMMONS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-4102
Practice Address - Country:US
Practice Address - Phone:330-425-2212
Practice Address - Fax:330-425-2779
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH994303Medicaid
OHF89182Medicare UPIN
OH4150692Medicare PIN