Individual
MELISSA A CAVALLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
804 GRANDVIEW DR, STE 1, EPHRATA, PA 17522-1635
(717) 733-2251
Mailing address
804 GRANDVIEW DR, STE 1, EPHRATA, PA 17522-1635
(717) 733-2251
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC005565
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013054770001
—
PA
01
—
1546063
GATEWAY
PA
01
—
1737441
HIGHMARK BLUE SHIELD
PA
01
—
50052060
CAPITAL BLUE CROSS
PA
Enumeration date
12/22/2005
Last updated
04/22/2008
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