Healthcare Provider Details

I. General information

NPI: 1811631740
Provider Name (Legal Business Name): MELISSA EZINNE CHIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEST RD STE 404
TOWSON MD
21204-2368
US

IV. Provider business mailing address

5801 POSTAL RD UNIT 81310
CLEVELAND OH
44181-2112
US

V. Phone/Fax

Practice location:
  • Phone: 410-832-5511
  • Fax: 410-832-5560
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0107962
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: