Provider Demographics
NPI:1497508014
Name:MELANCON, CHANCE MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANCE
Middle Name:MICHAEL
Last Name:MELANCON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3516
Mailing Address - Country:US
Mailing Address - Phone:504-331-7127
Mailing Address - Fax:
Practice Address - Street 1:1901 PERDIDO ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1393
Practice Address - Country:US
Practice Address - Phone:504-331-7127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program