Provider Demographics
NPI:1881770873
Name:MELNIK, TANYA EUGENA (MD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:EUGENA
Last Name:MELNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TATYANA
Other - Middle Name:
Other - Last Name:SOLOVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:720 WASHINGTON AVE SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2924
Mailing Address - Country:US
Mailing Address - Phone:612-884-0649
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:516 DELAWARE STREET SE, CINIC 3A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-884-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
04-06378OtherMEDICA CHOICE
131038OtherUCARE
WI34449700Medicaid
72G51MEOtherBLUE CROSS BLUE SHIELD
1033303OtherPREFERRED ONE
MN936494300Medicaid
04-00123OtherMEDICA PRIMARY
IA0988717Medicaid
2032919OtherARAZ
HP37602OtherHEALTH PARTNERS
131038OtherUCARE
1033303OtherPREFERRED ONE
MN936494300Medicaid