Davidson, Melissa M

Davidson, Melissa M is an individual health care provider with primary practice located at 4800 Olde Towne Pkwy Ste 150A , Marietta GA 30068-4357. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Davidson, Melissa M can be contacted via phone (770) 509-1025.

Contact Information

Primary practice address
4800 Olde Towne Pkwy Ste 150A Marietta GA 30068-4357
Phone: (770) 509-1025
Fax: (770) 509-1884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 002192 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002192 Georgia

Profile Details

NPI number 1578517876
LBN Legal business name Davidson, Melissa M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Feb 26th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578517876 NPPES
Georgia MEDICAID 100001575B
Georgia Other 10038125
Georgia Other 333457
Georgia MEDICAID 100001575C
Georgia MEDICAID 100001575

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