Basic Information
Provider Information
NPI: 1740418334
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINSON
FirstName: MELISSA
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BUSKEN
OtherFirstName: MELISSA
OtherMiddleName: R
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MELISSA ROSA, MD
OtherLastNameType: 5
Mailing Information
Address1: 1086 FRANKLIN ST
Address2:  
City: JOHNSTOWN
State: PA
PostalCode: 159054305
CountryCode: US
TelephoneNumber: 8144108300
FaxNumber: 8144108331
Practice Location
Address1: 1086 FRANKLIN ST
Address2:  
City: JOHNSTOWN
State: PA
PostalCode: 159054305
CountryCode: US
TelephoneNumber: 8145349763
FaxNumber: 8145343689
Other Information
ProviderEnumerationDate: 06/23/2009
LastUpdateDate: 11/17/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XLL31914SCN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XMD457839PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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