Individual
MELISHA BISSRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
739 THIMBLE SHOALS BLVD, SUITE 801, NEWPORT NEWS, VA 23606-3562
(757) 873-1009
(757) 873-7689
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101243205
VA
207RN0300X
Nephrology Physician
Primary
0101243205
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942417183
—
VA
Enumeration date
05/17/2007
Last updated
09/30/2013
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