Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1104460807 |
---|---|
Provider Name | Dr. Melissa Martell Senior |
First Address | Apex, NC 27502-2715 |
Second Address | Cary, NC 27511-4574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2019 |
Last Update Date | 06/08/2020 |