Individual
MRS. MELISSA DISMUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3562 THRESHFIELD ST, WHITE PLAINS, MD 20695-4200
(951) 240-8993
Mailing address
3562 THRESHFIELD ST, WHITE PLAINS, MD 20695-4200
(951) 240-8993
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/18/2017
Last updated
02/18/2017
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