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NPI Code Detail

MEDICARE: MELISSA ANN PYNNONEN MD

MEDICARE: MELISSA ANN PYNNONEN MD
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
1207Y00000XOtolaryngology Physician4301063973MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881782308
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN PYNNONEN MD
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-1633
Country : US
Telephone Number : 734-647-5299
Fax Number :
Provider Business Practice Location Address
First Line : 380 PARKLAND PLAZA
Second Line : 2ND FLOOR SUITE 210
City : ANN ARBOR
State : MI
Zip : 48103-6201
Country : US
Telephone Number : 734-998-7380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 01/18/2019

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Directions to “ MELISSA ANN PYNNONEN MD” Practice Location

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