Provider Demographics
NPI:1467455709
Name:MCMINN, MELINDA B (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:B
Last Name:MCMINN
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 1:736 IRVING AVE
Mailing Address - Street 2:CROUSE HOSPITAL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1687
Mailing Address - Country:US
Mailing Address - Phone:315-470-7426
Mailing Address - Fax:315-470-7283
Practice Address - Street 1:736 IRVING AVE
Practice Address - Street 2:CROUSE HOSPITAL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1687
Practice Address - Country:US
Practice Address - Phone:315-470-7426
Practice Address - Fax:315-470-7283
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208479207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine