Provider Demographics
NPI:1730462292
Name:DUNHAM, MELISSA SUE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SUE
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3031
Mailing Address - Country:US
Mailing Address - Phone:740-821-1105
Mailing Address - Fax:
Practice Address - Street 1:210 E EMMITT AVE
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1336
Practice Address - Country:US
Practice Address - Phone:740-947-2126
Practice Address - Fax:740-947-4149
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228191183500000X
FLPS45760183500000X
OH03-2-28191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist