Healthcare Provider Details

I. General information

NPI: 1023947835
Provider Name (Legal Business Name): MELISSA MCCARTHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 MOUNT ZION RD
MORROW GA
30260-2266
US

IV. Provider business mailing address

1115 MT.ZION RD BLDG A1 STE # 9
MORROW GA
30260-4171
US

V. Phone/Fax

Practice location:
  • Phone: 470-650-8626
  • Fax:
Mailing address:
  • Phone: 470-650-8626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: