Provider Demographics
NPI:1891710265
Name:DESILVA, MELANI (MD)
Entity type:Individual
Prefix:
First Name:MELANI
Middle Name:
Last Name:DESILVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10410 RIDGEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3500
Mailing Address - Country:US
Mailing Address - Phone:804-754-3776
Mailing Address - Fax:804-754-0880
Practice Address - Street 1:10410 RIDGEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-3500
Practice Address - Country:US
Practice Address - Phone:804-754-3776
Practice Address - Fax:804-754-0880
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012355072080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine