MEDICARE: STEPHANIE ONG MELLER M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	D0085545	MD

General Provider Information

NPI Number	:	1275941163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ONG MELLER M. D.

Provider Business Mailing Address
First Line	:	6357 OXON HILL RD
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-2214
Country	:	US
Telephone Number	:	301-839-2700
Fax Number	:	301-839-1354

Provider Business Practice Location Address
First Line	:	6357 OXON HILL RD
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-2214
Country	:	US
Telephone Number	:	301-839-2700
Fax Number	:	301-839-1354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2014
Last Update Date	:	06/27/2022

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