Melissa Dismuke
Individual provider Active NPI Contractor · White Plains, MD
NPI 1508305970 · NPPES record last updated Feb 18, 2017
Key facts
- NPI
- 1508305970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 3562 Threshfield St
White Plains, MD 20695-4200 - Phone
- (951) 240-8993
- NPI assigned
- Feb 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
3562 Threshfield St
White Plains, MD 20695-4200
Mailing address
3562 Threshfield St
White Plains, MD 20695-4200
Phone (951) 240-8993
Other providers in White Plains, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.