Provider Demographics
NPI:1295709392
Name:CLOUGH, MELISSA J (MD PC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:CLOUGH
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Gender:F
Credentials:MD PC
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Mailing Address - Street 1:100 MEDWAY RD
Mailing Address - Street 2:STE 401
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757
Mailing Address - Country:US
Mailing Address - Phone:508-634-7338
Mailing Address - Fax:508-634-7315
Practice Address - Street 1:100 MEDWAY RD
Practice Address - Street 2:STE 401
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757
Practice Address - Country:US
Practice Address - Phone:508-634-7338
Practice Address - Fax:508-634-7318
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-10-16
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Provider Licenses
StateLicense IDTaxonomies
MA153089207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59651Medicare UPIN
MAA23135Medicare ID - Type Unspecified