Provider Demographics
NPI:1629423264
Name:FARIAS, MELISA (DO)
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:FARIAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 BELLE CHASSE HWY STE B230
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7059
Mailing Address - Country:US
Mailing Address - Phone:045-341-0038
Mailing Address - Fax:504-341-0320
Practice Address - Street 1:1700 BELLE CHASSE HWY STE B230
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-7059
Practice Address - Country:US
Practice Address - Phone:504-341-0038
Practice Address - Fax:504-341-0320
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO4947207R00000X
LA341303207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine