Healthcare Provider Details

I. General information

NPI: 1861654865
Provider Name (Legal Business Name): MELISSA M MUNOZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN VALLEY RD STE 104
GREENSBORO NC
27408-7043
US

IV. Provider business mailing address

3 RICHLAND MEDICAL PARK DR SUITE 500
COLUMBIA SC
29203-6849
US

V. Phone/Fax

Practice location:
  • Phone: 336-387-2500
  • Fax: 336-387-2501
Mailing address:
  • Phone: 803-779-7316
  • Fax: 803-343-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberMD32520
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: