Provider Demographics
NPI:1932160793
Name:CARMAN, MELISSA SUE (MPT, ATC, CHT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:SUE
Last Name:CARMAN
Suffix:
Gender:F
Credentials:MPT, ATC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:801 ELKTON BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5323
Practice Address - Country:US
Practice Address - Phone:443-350-9056
Practice Address - Fax:443-350-9565
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005549225100000X
PAPT007686L225100000X
MD20976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0068377000OtherAMERIHEALTH UNDER IBC
PACK4276OtherPALMETTO GBA RR MEDICARE
PA03182100OtherCAPITAL BLUE CROSS
PA18444OtherHEALTH AMERICA
PA332313OtherHIGHMARK BLUE SHIELD
PA177124OtherMEDICARE HGS ADMINISTRATO
PA18444OtherHEALTH AMERICA