Provider Demographics
NPI:1740418334
Name:HINSON, MELISSA R (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:R
Last Name:HINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:R
Other - Last Name:BUSKEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MELISSA ROSA, MD
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-534-9763
Practice Address - Fax:814-534-3689
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL31914207P00000X
PAMD457839207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine