Provider Demographics
NPI:1891948048
Name:AMORN, MELISSA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MARIE
Last Name:AMORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8040 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5802
Mailing Address - Country:US
Mailing Address - Phone:513-853-9000
Mailing Address - Fax:513-246-5563
Practice Address - Street 1:8040 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5802
Practice Address - Country:US
Practice Address - Phone:513-853-9000
Practice Address - Fax:513-246-5563
Is Sole Proprietor?:No
Enumeration Date:2008-11-01
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC149547207Y00000X
CAA115925207Y00000X
OH35.151472207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA115925OtherSTATE MEDICAL LICENSE
CAFA2538126OtherFEDERAL DEA LICENSE