Provider Demographics
NPI:1285618959
Name:HAWKINS HOLT, MELISSA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LYNN
Last Name:HAWKINS HOLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 RHODES PL
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3968
Mailing Address - Country:US
Mailing Address - Phone:410-453-6266
Mailing Address - Fax:410-992-4441
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 226
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-992-7440
Practice Address - Fax:410-992-4441
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD57889207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401738200Medicaid
MDK910Medicare ID - Type Unspecified