Provider Demographics
NPI:1861595050
Name:NIEMAN, MELINDA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:ANN
Last Name:NIEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:ANN
Other - Last Name:NIEBUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2052 PRINCETON ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011
Mailing Address - Country:US
Mailing Address - Phone:513-863-6383
Mailing Address - Fax:513-863-9882
Practice Address - Street 1:2052 PRINCETON ROAD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011
Practice Address - Country:US
Practice Address - Phone:513-863-6383
Practice Address - Fax:513-863-9882
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-2970-N2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNI4154441Medicare ID - Type Unspecified
OHI28468Medicare UPIN