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NPI Code Detail

MEDICARE: DR. MELISSA LEE-AGAWA M.D.

MEDICARE: DR. MELISSA LEE-AGAWA 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
1207V00000XObstetrics & Gynecology PhysicianMD459757PA

General Provider Information

NPI Number : 1831506492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA LEE-AGAWA M.D.
Provider Business Mailing Address
First Line : 3509 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-4105
Country : US
Telephone Number : 215-707-2433
Fax Number :
Provider Business Practice Location Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5103
Country : US
Telephone Number : 215-707-3008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2014
Last Update Date : 01/22/2026

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