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NPI Code Detail

MEDICARE: MELISSA HULTMAN PA-C

MEDICARE:   MELISSA  HULTMAN  PA-C
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
1363A00000XPhysician Assistant5601007886MI

General Provider Information

NPI Number : 1639626922
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA HULTMAN PA-C
Provider Business Mailing Address
First Line : 5515 CLEVELAND AVE STE 1
Second Line :
City : STEVENSVILLE
State : MI
Zip : 49127-9669
Country : US
Telephone Number : 269-429-6604
Fax Number :
Provider Business Practice Location Address
First Line : 5515 CLEVELAND AVE STE 1
Second Line :
City : STEVENSVILLE
State : MI
Zip : 49127-9669
Country : US
Telephone Number : 269-429-6604
Fax Number : 269-429-1715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2016
Last Update Date : 05/13/2025

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Directions to “ MELISSA HULTMAN PA-C” Practice Location

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