Healthcare Provider Details

I. General information

NPI: 1932239381
Provider Name (Legal Business Name): MELINDA RICKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30265 COMMERCE DR SUITE 207
MILLSBORO DE
19966-3593
US

IV. Provider business mailing address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

V. Phone/Fax

Practice location:
  • Phone: 302-732-8400
  • Fax: 302-934-6705
Mailing address:
  • Phone: 410-543-7531
  • Fax: 410-912-6386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC50000256
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: