Provider Demographics
NPI:1891722914
Name:PAVLECHKO, MELINDA L (PA-C)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:L
Last Name:PAVLECHKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7534 SAUNDERLANE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1823
Mailing Address - Country:US
Mailing Address - Phone:614-580-7036
Mailing Address - Fax:
Practice Address - Street 1:7534 SAUNDERLANE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1823
Practice Address - Country:US
Practice Address - Phone:614-580-7036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.000202RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0627576Medicaid