Healthcare Provider Details

I. General information

NPI: 1265838627
Provider Name (Legal Business Name): MICHELLE CLARE MELCHIORRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 JACKSON ST
LOWELL MA
01852-2103
US

IV. Provider business mailing address

161 JACKSON ST
LOWELL MA
01852-2103
US

V. Phone/Fax

Practice location:
  • Phone: 978-937-9700
  • Fax: 978-221-6728
Mailing address:
  • Phone: 978-937-9700
  • Fax: 978-221-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number3021308
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: