Provider Demographics
NPI:1609840099
Name:HADDOX, MELANIE SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:SUSAN
Last Name:HADDOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:SCHRAEMEYER AND THOMBRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2639 UPTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3936
Mailing Address - Country:US
Mailing Address - Phone:419-471-1848
Mailing Address - Fax:419-471-0037
Practice Address - Street 1:2639 UPTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3936
Practice Address - Country:US
Practice Address - Phone:419-471-1848
Practice Address - Fax:419-471-0037
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047294T2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0593237Medicaid
E29811Medicare UPIN
OHTH0644372Medicare ID - Type Unspecified