Healthcare Provider Details

I. General information

NPI: 1184882789
Provider Name (Legal Business Name): IHOR V MELNYTSKYY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE ROAD CONWAY MEDICAL CENTER
CONWAY SC
29526
US

IV. Provider business mailing address

1921 SANDGATE CT
NAPERVILLE IL
60565-2306
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-7111
  • Fax:
Mailing address:
  • Phone: 630-946-6885
  • Fax: 864-455-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberTL30811
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number81569
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.130854
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: