Provider Demographics
NPI:1669572376
Name:LAWRENCE, MELISSA J (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:TANSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45-602 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2017
Mailing Address - Country:US
Mailing Address - Phone:808-432-3800
Mailing Address - Fax:
Practice Address - Street 1:45-602 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2017
Practice Address - Country:US
Practice Address - Phone:808-432-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11093207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000236398OtherHMSA BILLING NUMBER
HI518847-02Medicaid
HI518847-02Medicaid
HIH54722Medicare PIN