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General NPI Number Information
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NPI Number | 1598097552
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Entity Type | Individual
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Provider Name | MELINDA J SMEAD PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 3737 MARKET ST 7TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5545
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Country | US
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Telephone | 215-662-3340
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Fax | 215-222-8875
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Provider Business Mailing Address
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Address Line | 3737 MARKET ST 7 TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5545
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Country | US
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Telephone | 215-662-3340
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Fax | 215-222-8875
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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 | C0004134
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA055974
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License Number State | PA
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