Healthcare Provider Details

I. General information

NPI: 1013017029
Provider Name (Legal Business Name): MELISSA MCLANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/25/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 CRANBERRY SPRINGS DR SUITE 100
CRANBERRY TOWNSHIP PA
16066-6687
US

IV. Provider business mailing address

2 HOT METAL ST QUANTUM ONE
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 724-720-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License NumberOS010610L
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: