Healthcare Provider Details

I. General information

NPI: 1659363885
Provider Name (Legal Business Name): FIONA F MELLER AZRIELI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FIONA FAITH MELLER MD

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 06/13/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 TWIN SPRINGS RD
HALETHORPE MD
21227-3553
US

IV. Provider business mailing address

1701 TWIN SPRINGS RD
HALETHORPE MD
21227-3553
US

V. Phone/Fax

Practice location:
  • Phone: 410-737-5520
  • Fax: 410-737-5521
Mailing address:
  • Phone: 410-737-5520
  • Fax: 410-737-5521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD70477
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD038639
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101247347
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD70477
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: