MEDICARE: MELISSA A PIFER MD

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	207Q00000X	Family Medicine Physician	35130855	OH

General Provider Information

NPI Number	:	1396150009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A PIFER MD

Provider Business Mailing Address
First Line	:	128 DEPOT ST
Second Line	:
City	:	WAUSEON
State	:	OH
Zip	:	43567-1305
Country	:	US
Telephone Number	:	419-335-0351
Fax Number	:	419-335-0397

Provider Business Practice Location Address
First Line	:	128 DEPOT ST
Second Line	:
City	:	WAUSEON
State	:	OH
Zip	:	43567-1305
Country	:	US
Telephone Number	:	419-335-0351
Fax Number	:	419-335-0397

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

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	07/21/2022

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Directions to “ MELISSA A PIFER MD” Practice Location

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