Provider Demographics
NPI:1992371173
Name:ROBERTS, MELISSA DANILLE (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DANILLE
Last Name:ROBERTS
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 1:101 STADIUM DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-7911
Mailing Address - Country:US
Mailing Address - Phone:304-598-4850
Mailing Address - Fax:304-598-4871
Practice Address - Street 1:101 STADIUM DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-7911
Practice Address - Country:US
Practice Address - Phone:304-598-4850
Practice Address - Fax:304-598-4871
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program