Individual
MICHAEL RAY MELANCON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD015178
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015178
LA STATE LICENSE
LA
05
—
1324833
—
LA
01
—
721165262
FEDERAL TAX ID
LA
Enumeration date
07/06/2006
Last updated
07/08/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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