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General NPI Number Information
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NPI Number | 1639199201
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Entity Type | Individual
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Provider Name | MELISSA K RICHARDSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 180 HALTON RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3508
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Country | US
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Telephone | 864-234-7654
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Fax | 888-412-1282
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Provider Business Mailing Address
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Address Line | PO BOX 631341
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City | CINCINNATI
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State | OH
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Zip | 45263-1341
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Country | US
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Telephone |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 20894
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License Number State | SC
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