Healthcare Provider Details

I. General information

NPI: 1902178023
Provider Name (Legal Business Name): MELISSA PAGAN PARES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 WEST ST STE 304
ANNAPOLIS MD
21401-3556
US

IV. Provider business mailing address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

V. Phone/Fax

Practice location:
  • Phone: 443-203-8202
  • Fax: 443-203-8601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberD81960
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: