MEDICARE: DR. MELISA MULLINS 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	2080P0207X	Pediatric Hematology & Oncology Physician	4301074662	MI
2	2080P0207X	Pediatric Hematology & Oncology Physician	35126161	OH

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1417961137	OTHER	MI	BCBSM - BRONSON

General Provider Information

NPI Number	:	1417071226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISA MULLINS M.D.

Provider Business Mailing Address
First Line	:	2222 CHERRY ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2673
Country	:	US
Telephone Number	:	419-251-8210
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 CHERRY ST
Second Line	:	SUITE 2800
City	:	TOLEDO
State	:	OH
Zip	:	43608-2675
Country	:	US
Telephone Number	:	419-251-8210
Fax Number	:	419-251-7700

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	06/16/2023

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Directions to “ DR. MELISA MULLINS M.D.” Practice Location

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