Provider Demographics
NPI:1194024315
Name:KOUNS, MELISSA MAE (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAE
Last Name:KOUNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MAE
Other - Last Name:LINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6507 HARRISON AVE UNIT N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2815
Mailing Address - Country:US
Mailing Address - Phone:513-981-4242
Mailing Address - Fax:513-347-5050
Practice Address - Street 1:6507 HARRISON AVE UNIT N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2815
Practice Address - Country:US
Practice Address - Phone:513-981-4242
Practice Address - Fax:513-347-5050
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059163207R00000X, 208000000X
SC38072207R00000X
OH35135424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC380723Medicaid
SCSC62909223Medicare UPIN