Healthcare Provider Details

I. General information

NPI: 1497982649
Provider Name (Legal Business Name): MELISSA AMBER BURGESS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 CENTRE AVE HILLMAN CANCER CENTER, 2ND FLOOR
PITTSBURGH PA
15232-1301
US

IV. Provider business mailing address

5115 CENTRE AVE 2ND FLOOR
PITTSBURGH PA
15232-1301
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-4724
  • Fax: 412-692-4705
Mailing address:
  • Phone: 412-692-4724
  • Fax: 412-692-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD445720
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: