Provider Demographics
NPI:1891051512
Name:QUINN, MELISSA DAWN MCKEAN (MD)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:DAWN MCKEAN
Last Name:QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 BRODIE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5610
Mailing Address - Country:US
Mailing Address - Phone:512-462-1936
Mailing Address - Fax:833-448-3184
Practice Address - Street 1:9805 BRODIE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5610
Practice Address - Country:US
Practice Address - Phone:512-462-1936
Practice Address - Fax:833-448-3184
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX516819ZJCMedicare UPIN