Individual
DR. MELISSA ANN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4613 W MAIN ST, KALAMAZOO, MI 49006-2645
(269) 488-8672
(269) 488-8673
Mailing address
4613 W MAIN ST, SUITE A, KALAMAZOO, MI 49006-2645
(269) 488-8672
(269) 488-8673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301056179
MI
208000000X
Pediatrics Physician
4301056179
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103904921
BCBS
—
01
—
110C913020
BCBS GRP PIN
—
01
—
156671
GREAT LAKES HLTH PLN
—
05
—
4195269
—
MI
05
—
487647710
—
MI
01
—
5551271
AETNA PIN
—
Enumeration date
03/16/2006
Last updated
11/27/2023
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