Provider Demographics
NPI:1952753816
Name:MELLON, MEGHAN MAPLES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:MAPLES
Last Name:MELLON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21720 CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-0150
Mailing Address - Country:US
Mailing Address - Phone:704-895-5773
Mailing Address - Fax:
Practice Address - Street 1:21720 CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-0150
Practice Address - Country:US
Practice Address - Phone:704-895-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-04
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist