Provider Demographics
NPI:1194802702
Name:CONTI, MELISSA M (PA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:M
Last Name:CONTI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:ECKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4801 DORSEY HALL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7766
Mailing Address - Country:US
Mailing Address - Phone:410-997-4780
Mailing Address - Fax:410-997-3196
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-997-7660
Practice Address - Fax:410-997-5377
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine