Individual
MAUREEN MILLER PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 301-2440
(859) 301-2493
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-2440
(859) 301-2493
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27524
KY
207V00000X
Obstetrics & Gynecology Physician
Primary
27524
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2678866
—
OH
05
—
64275241
—
KY
Enumeration date
09/26/2005
Last updated
09/06/2018
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