MEDICARE: MIKAELA MELNYCHUK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1467244798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKAELA MELNYCHUK

Provider Business Mailing Address
First Line	:	350 HOWARD ST
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3515
Country	:	US
Telephone Number	:	864-327-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 PLYMOUTH RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-2801
Country	:	US
Telephone Number	:	734-764-3270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	04/04/2026

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Directions to “ MIKAELA MELNYCHUK ” Practice Location

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