MEDICARE: MELISSA JANE GAMMIE PA-C

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	363A00000X	Physician Assistant	MA001891L	PA
2	363AM0700X	Medical Physician Assistant	MA001891L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20019276	OTHER	PA	AMERIHEALTH MERCY-WMG
2	50000130	OTHER	PA	CAPITAL BLUE CROSS-WMG
3	1551696	OTHER	PA	GATEWAY-WMG
4	1916744	OTHER	PA	HIGHMARK FREEDOM BLUE

General Provider Information

NPI Number	:	1851329163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA JANE GAMMIE PA-C

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-812-4900
Fax Number	:	717-259-7262

Provider Business Practice Location Address
First Line	:	105 4TH ST
Second Line	:
City	:	EAST BERLIN
State	:	PA
Zip	:	17316-9638
Country	:	US
Telephone Number	:	717-812-4900
Fax Number	:	717-259-7262

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	06/13/2016

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