Provider Demographics
NPI:1588770895
Name:WARNER, MELISSA LEE (MD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEE
Last Name:WARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:LEE
Other - Last Name:STUMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:89 STATION TRAIL
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534
Mailing Address - Country:US
Mailing Address - Phone:404-358-4600
Mailing Address - Fax:706-219-3078
Practice Address - Street 1:310 BLACK BEAR RDG
Practice Address - Street 2:
Practice Address - City:SAUTEE
Practice Address - State:GA
Practice Address - Zip Code:30571-3500
Practice Address - Country:US
Practice Address - Phone:470-539-6905
Practice Address - Fax:706-219-3078
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA33480207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine