Provider Demographics
NPI:1447472485
Name:CHARNESKY, MELISSA AMY (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:AMY
Last Name:CHARNESKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:CHARNESKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-824-6194
Mailing Address - Fax:419-824-0356
Practice Address - Street 1:5700 MONROE ST UNIT 310
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2768
Practice Address - Country:US
Practice Address - Phone:419-824-6194
Practice Address - Fax:419-824-0356
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI5101016489207YS0123X
FLOS10818207YS0123X
OH34.014359207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447472485Medicaid