Provider Demographics
NPI:1770792368
Name:HOISINGTON, MELISSA KRSTOV (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KRSTOV
Last Name:HOISINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26850 PROVIDENCE PKWY STE 455
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1265
Mailing Address - Country:US
Mailing Address - Phone:248-465-4847
Mailing Address - Fax:248-465-4477
Practice Address - Street 1:26850 PROVIDENCE PKWY STE 455
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1265
Practice Address - Country:US
Practice Address - Phone:248-465-4847
Practice Address - Fax:248-465-4477
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010779942080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine