Provider Demographics
NPI:1790896256
Name:STREETER, MELISSA J (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:STREETER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-721-8700
Mailing Address - Fax:207-721-8715
Practice Address - Street 1:121 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2700
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2653
Practice Address - Country:US
Practice Address - Phone:207-721-8700
Practice Address - Fax:207-721-8715
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEMD16266207VG0400X, 207VF0040X
MEMD016266207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENX4898Medicare PIN
MEH96454Medicare UPIN