MEDICARE: MELISSA RYAN ROBINSON M.D.

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	208000000X	Pediatrics Physician	LL37197	SC
2	208000000X	Pediatrics Physician	37197	SC

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

General Provider Information

NPI Number	:	1366856114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA RYAN ROBINSON M.D.

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 CROSS PARK CT
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29605-4264
Country	:	US
Telephone Number	:	864-220-7270
Fax Number	:

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

Provider Enumeration Date	:	06/19/2014
Last Update Date	:	06/27/2023

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