Individual
MS. MELISSA JOSE GAMPONIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
208 MACCORKLE AVE SE, CHARLESTON, WV 25314-1160
(304) 343-4300
(304) 343-5473
Mailing address
208 MACCORKLE AVE SE, CHARLESTON, WV 25314-1160
(304) 343-4300
(304) 343-5473
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17020
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000372286
MS BCBS
WV
05
—
0125358000
—
WV
Enumeration date
09/27/2006
Last updated
01/03/2014
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