Provider Demographics
NPI:1699096339
Name:ANDRIC, MELISSA LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LYNN
Last Name:ANDRIC
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1135 W UNIVERSITY DR STE 425
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1897
Mailing Address - Country:US
Mailing Address - Phone:248-650-5861
Mailing Address - Fax:248-650-5865
Practice Address - Street 1:8391 COMMERCE RD STE 107
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4489
Practice Address - Country:US
Practice Address - Phone:248-360-8660
Practice Address - Fax:248-360-9235
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2015-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018930208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation