Basic Information
| Provider Information | |||||||||
| NPI: | 1962630202 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUDDENSEE | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | MIHELIDAKIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MIHELIDAKIS | ||||||||
| OtherFirstName: | MELISSA | ||||||||
| OtherMiddleName: | DEMETRA | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 155 MAIN ST | ||||||||
| Address2: | ACHS FRANCONIA | ||||||||
| City: | FRANCONIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038237078 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1095 PROFILE RD STE B | ||||||||
| Address2: | |||||||||
| City: | FRANCONIA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035804938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038237078 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 06/02/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | RT 1913 | NH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 15562 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.