Provider Demographics
NPI:1184157471
Name:KING, MELISSA L (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:KING
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-656-6122
Mailing Address - Fax:717-656-0142
Practice Address - Street 1:368 W MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:LEOLA
Practice Address - State:PA
Practice Address - Zip Code:17540-1761
Practice Address - Country:US
Practice Address - Phone:717-656-6122
Practice Address - Fax:717-656-0142
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471477207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine