Provider Demographics
NPI:1336172758
Name:MELHEM, LINA Y (MD)
Entity Type:Individual
Prefix:DR
First Name:LINA
Middle Name:Y
Last Name:MELHEM
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-706-1622
Mailing Address - Fax:410-706-1626
Practice Address - Street 1:827 LINDEN AVE
Practice Address - Street 2:FLOOR 2, SOUTH
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4606
Practice Address - Country:US
Practice Address - Phone:443-682-6800
Practice Address - Fax:443-552-2991
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD46168207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD261802800Medicaid
MDS062-0493OtherCAREFIRST BC/BS
MD261802800Medicaid
MD257590ZADHMedicare PIN