Basic Information
| Provider Information | |||||||||
| NPI: | 1336191725 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YADAO | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8926 WOODYARD RD | ||||||||
| Address2: | SUITE 701 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207354220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8101 HINSON FARM RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223063403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018561682 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 03/21/2011 | ||||||||
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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 | 207X00000X | 0101058134 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 145530100 | 01 | DEPARTMENT OF LABOR | OTHER | 176608 | 01 | METRO MEDICARE GROUP PTAN | OTHER | 010017637 | 05 | VA | MEDICAID | 4695-0043 | 01 | CAREFIRST NCA | OTHER | 017482YZW | 01 | METRO MEDICARE INDIVIDUAL PROVIDER # | OTHER | 10981133 | 01 | VA | CAQH | OTHER | P00887808 | 01 | RAILROAD MEDICARE | OTHER |