Provider Demographics
NPI:1972949543
Name:CORBIN, MELISSA NICOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:NICOLE
Last Name:CORBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NICOLE
Other - Last Name:PALM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2448 HOLLY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3148
Mailing Address - Country:US
Mailing Address - Phone:410-841-5355
Mailing Address - Fax:410-349-5033
Practice Address - Street 1:2448 HOLLY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3148
Practice Address - Country:US
Practice Address - Phone:410-841-5355
Practice Address - Fax:410-349-5033
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical