Provider Demographics
NPI:1841456936
Name:SEGEV, MELISSA (AUD)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:SEGEV
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:TAMRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:79 FOREST PLZ
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3716
Mailing Address - Country:US
Mailing Address - Phone:410-266-6444
Mailing Address - Fax:866-247-5947
Practice Address - Street 1:7113 AMBASSADOR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2725
Practice Address - Country:US
Practice Address - Phone:410-944-3100
Practice Address - Fax:866-643-0039
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01149231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11864707OtherCAQH