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NPI Code Detail

MEDICARE: MELISSA BIRCH

MEDICARE:   MELISSA  BIRCH
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1649771767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA BIRCH
Provider Business Mailing Address
First Line : 420 E SOUTH TEMPLE STE 520
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-1362
Country : US
Telephone Number : 385-626-5907
Fax Number :
Provider Business Practice Location Address
First Line : 420 E SOUTH TEMPLE STE 520
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-1362
Country : US
Telephone Number : 385-626-5907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2018
Last Update Date : 02/23/2018

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Directions to “ MELISSA BIRCH ” Practice Location

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