Provider Demographics
NPI:1972866143
Name:RAU, MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:RAU
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 1:6521 STEUBENVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-1005
Mailing Address - Country:US
Mailing Address - Phone:412-749-6920
Mailing Address - Fax:412-749-6779
Practice Address - Street 1:6521 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1005
Practice Address - Country:US
Practice Address - Phone:412-749-6920
Practice Address - Fax:412-749-6779
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201458390200000X
PAMD453852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program