Provider Demographics
NPI:1932425428
Name:TAYLOR, MELISSA MCLANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MCLANE
Last Name:TAYLOR
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1440
Mailing Address - Fax:
Practice Address - Street 1:16139 LANCASTER HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2033
Practice Address - Country:US
Practice Address - Phone:704-384-1440
Practice Address - Fax:704-384-1452
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-02272208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics