Provider Demographics
NPI:1285878827
Name:HUNGLER, MELANIE (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HUNGLER
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT, PHYS DIV
Mailing Address - Street 2:2ND FL, CBO2-3, ATTN: CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219
Mailing Address - Country:US
Mailing Address - Phone:513-263-8571
Mailing Address - Fax:513-366-4480
Practice Address - Street 1:7759 UNIVERSITY DR
Practice Address - Street 2:SUITE G
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6578
Practice Address - Country:US
Practice Address - Phone:513-721-7373
Practice Address - Fax:513-977-4253
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50001734363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068585OtherMEDICAID
OH270577733079OtherCARESOURCE
OH779386/713428OtherBUCKEYE MEDICAID/MEDICARE
OHP01238565OtherRAILROAD MEDICARE
OH610902OtherWELLCARE
OH720614OtherANTHEM
OH1447371737OtherMEDICAL MUTUAL
OHH021220OtherMEDICARE
OH1632131OtherGATEWAY HEALTH
OH9720708OtherAETNA