Healthcare Provider Details

I. General information

NPI: 1740369032
Provider Name (Legal Business Name): CHRISTOPHER JOSEPH MELCHIORRE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 S TALBOT ST SUITE 10
ST MICHAELS MD
21663-2637
US

IV. Provider business mailing address

463 TIMBER LN
GRASONVILLE MD
21638-1263
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-4613
  • Fax: 410-822-6534
Mailing address:
  • Phone: 410-822-4613
  • Fax: 410-822-6534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17171
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: