Provider Demographics
NPI:1154717874
Name:WINDON, MELINA J (MD)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:J
Last Name:WINDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELINA
Other - Middle Name:
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE B300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-5000
Practice Address - Country:US
Practice Address - Phone:859-257-5405
Practice Address - Fax:859-323-5483
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301506857207Y00000X
KYTP672207Y00000X
KY58531207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP32911OtherMD TRAINING REGISTRATION