Individual
MELISSA ANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
970 W WOOSTER ST, SUITE 130, BOWLING GREEN, OH 43402-1600
(419) 352-6890
(419) 353-2415
Mailing address
745 HASKINS RD, SUITE B, BOWLING GREEEN, OH 43402-1600
(419) 353-7069
(419) 353-7076
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.123460
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107233
—
OH
Enumeration date
06/20/2011
Last updated
11/23/2020
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