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General NPI Number Information
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NPI Number | 1467787234
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Entity Type | Individual
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Provider Name | MELISSA MARIE MCMINN PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/12/2009
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 3601 5TH AVE STE 6B
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City | PITTSBURGH
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State | PA
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Zip | 15213-3403
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Country | US
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Telephone | 412-648-8976
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Fax |
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Provider Business Mailing Address
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Address Line | 320 BROOKHAVEN LN
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City | PITTSBURGH
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State | PA
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Zip | 15241-2582
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Country | US
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Telephone | 412-877-6724
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 013545-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MM4243250
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License Number State | PA
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