Provider Demographics
NPI:1770570798
Name:AMSTER, MELANIE INA (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:INA
Last Name:AMSTER
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 1:919 CONESTOGA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1352
Mailing Address - Country:US
Mailing Address - Phone:610-525-6580
Mailing Address - Fax:610-525-3664
Practice Address - Street 1:919 CONESTOGA RD STE 300
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:610-525-6580
Practice Address - Fax:215-563-1783
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061880L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001638767Medicaid
PA896993GCUMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER#