Healthcare Provider Details

I. General information

NPI: 1083812358
Provider Name (Legal Business Name): MELISSA EMERSON LANCER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA K EMERSON MD

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 OSLER DR
TOWSON MD
21204-7700
US

IV. Provider business mailing address

7601 OSLER DR
TOWSON MD
21204-7700
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-1000
  • Fax:
Mailing address:
  • Phone: 410-337-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0070665
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierD0070665
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerMD LICENSE
# 2
IdentifierLL1762
Identifier TypeOTHER
Identifier StateNV
Identifier IssuerMV MEDICAL LIC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: