Provider Demographics
NPI:1356761241
Name:ROBINSON, MELISSA DUNAVANT (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DUNAVANT
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0069
Mailing Address - Country:US
Mailing Address - Phone:828-649-9566
Mailing Address - Fax:
Practice Address - Street 1:590 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6807
Practice Address - Country:US
Practice Address - Phone:828-649-3500
Practice Address - Fax:828-649-1032
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01036207Q00000X
TN54317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ074893Medicaid
NC1356761241Medicaid