Basic Information
| Provider Information | |||||||||
| NPI: | 1306860879 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRIVER | ||||||||
| FirstName: | MELORA | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TROTTER | ||||||||
| OtherFirstName: | MELORA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1028 LEE ANN DR NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047821892 | ||||||||
| FaxNumber: | 7047861890 | ||||||||
| Practice Location | |||||||||
| Address1: | 1028 LEE ANN DR NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047821892 | ||||||||
| FaxNumber: | 7047861890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 04/23/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 200500686 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.