Provider Demographics
NPI:1780897249
Name:STOKES, MELISSA CARIN (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CARIN
Last Name:STOKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:CARIN
Other - Last Name:PELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:63 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16933-1262
Mailing Address - Country:US
Mailing Address - Phone:705-662-7600
Mailing Address - Fax:705-662-7726
Practice Address - Street 1:63 3RD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:PA
Practice Address - Zip Code:16933-1262
Practice Address - Country:US
Practice Address - Phone:570-662-7600
Practice Address - Fax:570-662-7600
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4458212084P0800X
VA0116018964390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA243415Medicare PIN
MO152360380Medicare UPIN