Provider Demographics
NPI:1356898696
Name:ULAS, MELISSA M (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:ULAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3500 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5189
Practice Address - Country:US
Practice Address - Phone:215-707-4353
Practice Address - Fax:215-707-2781
Is Sole Proprietor?:No
Enumeration Date:2016-09-03
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD483458208D00000X, 207ZP0104X
246QC1000X, 247ZC0005X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No246QC1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyChemistry
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No171400000XOther Service ProvidersHealth & Wellness Coach