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General NPI Number Information
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NPI Number | 1144313172
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Entity Type | Individual
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Provider Name | MELISSA HAIKAL BEVINS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 10710 SIKES PL STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28277-8194
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Country | US
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Telephone | 704-248-5101
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Fax | 704-482-5120
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Provider Business Mailing Address
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Address Line | 3158 FREEDOM DR STE 3102
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City | CHARLOTTE
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State | NC
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Zip | 28208-0014
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Country | US
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Telephone | 704-971-7099
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Fax | 704-971-0035
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 01088
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License Number State | WV
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