Healthcare Provider Details

I. General information

NPI: 1114151750
Provider Name (Legal Business Name): MELISSA H RATLIFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW NC
28173-5020
US

IV. Provider business mailing address

104 WAXHAW PROFESSIONAL PARK DR STE D
WAXHAW NC
28173-5020
US

V. Phone/Fax

Practice location:
  • Phone: 704-443-8530
  • Fax: 704-755-6528
Mailing address:
  • Phone: 704-443-8530
  • Fax: 704-755-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number156955
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: