Provider Demographics
NPI:1962098087
Name:TUMA, MELISSA MAE (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MAE
Last Name:TUMA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:131-752-8480
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12750 ST FRANCIS DR STE 320
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-662-0077
Practice Address - Fax:219-662-9496
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2024-01-12
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Provider Licenses
StateLicense IDTaxonomies
IN10003195A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant