Healthcare Provider Details

I. General information

NPI: 1659611291
Provider Name (Legal Business Name): MELISSA SHEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 07/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15855 19 MILE RD HENRY FORD MACOMB HOSPITALS
CLINTON TOWNSHIP MI
48038-3504
US

IV. Provider business mailing address

1 HOSPITAL PLAZA
STAMFORD CT
06902
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number56071
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: