Healthcare Provider Details

I. General information

NPI: 1639280753
Provider Name (Legal Business Name): MELISSA JOAN TERCHEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 S 16TH ST STE A
WILMINGTON NC
28401-6491
US

IV. Provider business mailing address

PO BOX 15109
WILMINGTON NC
28408-5109
US

V. Phone/Fax

Practice location:
  • Phone: 910-452-8633
  • Fax: 910-452-8569
Mailing address:
  • Phone: 910-392-2525
  • Fax: 910-392-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number24054
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02274
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: