Provider Demographics
NPI:1588627590
Name:MELVIN, RONALD C (DO)
Entity type:Individual
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First Name:RONALD
Middle Name:C
Last Name:MELVIN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:812 E JOLLY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6818
Mailing Address - Country:US
Mailing Address - Phone:517-346-8410
Mailing Address - Fax:517-346-8291
Practice Address - Street 1:838 LOUISA ST
Practice Address - Street 2:SUITE B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-0214
Practice Address - Country:US
Practice Address - Phone:517-887-5200
Practice Address - Fax:517-887-5279
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-08-01
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Provider Licenses
StateLicense IDTaxonomies
MI51010107062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI112762842Medicaid
MI112762842Medicaid