MEDICARE: MELVA DIXON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	172V00000X	Community Health Worker
4	1744P3200X	Prosthetics Case Management	MD
5	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831957398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVA DIXON

Provider Business Mailing Address
First Line	:	6118 SEA LION PL
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20603-4448
Country	:	US
Telephone Number	:	301-583-6535
Fax Number	:

Provider Business Practice Location Address
First Line	:	2782 OLD WASHINGTON RD
Second Line	:	GLAMOR GIRL BUILDING SUITE B
City	:	WALDORF
State	:	MD
Zip	:	20601-3176
Country	:	US
Telephone Number	:	301-583-6535
Fax Number	:

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

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/02/2026

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Directions to “ MELVA DIXON ” Practice Location

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