Healthcare Provider Details

I. General information

NPI: 1598348633
Provider Name (Legal Business Name): MELISSA ALEJANDRA HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 THOMAS JOHNSON DR STE H
FREDERICK MD
21702-4893
US

IV. Provider business mailing address

77 THOMAS JOHNSON DR STE H
FREDERICK MD
21702-4893
US

V. Phone/Fax

Practice location:
  • Phone: 301-414-2300
  • Fax:
Mailing address:
  • Phone: 301-414-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0106412
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: