Provider Demographics
NPI:1013145028
Name:LAW, MELISSA KAREN (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAREN
Last Name:LAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:KAREN
Other - Last Name:MAROHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-0550
Mailing Address - Country:US
Mailing Address - Phone:308-382-1100
Mailing Address - Fax:308-385-0796
Practice Address - Street 1:2444 W FAIDLEY AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4327
Practice Address - Country:US
Practice Address - Phone:308-382-1100
Practice Address - Fax:308-385-0796
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6009208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics