Healthcare Provider Details

I. General information

NPI: 1033048459
Provider Name (Legal Business Name): MELAPOP AESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 EAGLES LANDING PKWY
STOCKBRIDGE GA
30281-7279
US

IV. Provider business mailing address

100 POSTMASTER DR UNIT 1092
MCDONOUGH GA
30253-2812
US

V. Phone/Fax

Practice location:
  • Phone: 470-409-1861
  • Fax:
Mailing address:
  • Phone: 469-359-1824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STARASIA ABRAHAM
Title or Position: OWNER
Credential: FOUNDER
Phone: 470-409-1861