MEDICARE: MELANIE HUNGLER PHYSICIAN ASSISTANT

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	363AM0700X	Medical Physician Assistant	50001734	OH
2	363AS0400X	Surgical Physician Assistant	50001734	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	779386/713428	OTHER	OH	BUCKEYE MEDICAID/MEDICARE
4	P01238565	OTHER	OH	RAILROAD MEDICARE
8	H021220	OTHER	OH	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	270577733079	OTHER	OH	CARESOURCE
5	610902	OTHER	OH	WELLCARE
6	720614	OTHER	OH	ANTHEM
7	1447371737	OTHER	OH	MEDICAL MUTUAL
9	1632131	OTHER	OH	GATEWAY HEALTH
10	9720708	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1285878827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE HUNGLER PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	237 WILLIAM HOWARD TAFT, PHYS DIV
Second Line	:	2ND FL, CBO2-3, ATTN: CREDENTIALING
City	:	CINCINNATI
State	:	OH
Zip	:	45219
Country	:	US
Telephone Number	:	513-263-8571
Fax Number	:	513-366-4480

Provider Business Practice Location Address
First Line	:	7759 UNIVERSITY DR
Second Line	:	SUITE G
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6578
Country	:	US
Telephone Number	:	513-721-7373
Fax Number	:	513-977-4253

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

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	02/10/2015

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