Healthcare Provider Details

I. General information

NPI: 1457882565
Provider Name (Legal Business Name): MONICA NIERLE MELMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST
RICHMOND VA
23298-5025
US

IV. Provider business mailing address

501 N 2ND ST FL 4
RICHMOND VA
23219-1359
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-0762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number41037
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101275330
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: