Provider Demographics
NPI:1437107851
Name:HUNTER, MELISSA HODGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:HODGE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SEVEN FARMS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7553
Mailing Address - Country:US
Mailing Address - Phone:843-856-1771
Mailing Address - Fax:843-856-8788
Practice Address - Street 1:245 SEVEN FARMS DR STE 110
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492
Practice Address - Country:US
Practice Address - Phone:843-856-1771
Practice Address - Fax:843-856-8788
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL2150Medicaid
SCD90841Medicare UPIN
SCD908418284Medicare ID - Type Unspecified