Provider Demographics
NPI:1952691164
Name:MACOMBER-ESTILL, MELISSA LINDSEY (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LINDSEY
Last Name:MACOMBER-ESTILL
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 1:4320 SEMINARY RD # 3000
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1535
Mailing Address - Country:US
Mailing Address - Phone:703-504-3069
Mailing Address - Fax:703-504-3029
Practice Address - Street 1:4320 SEMINARY RD # 3000
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3069
Practice Address - Fax:703-504-3029
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012617152080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine