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Individual

MELISSA JUSTINE MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
1500 JAMES SIMPSON JR WAY, COVINGTON, KY 41011
(859) 655-4111
(859) 655-4815
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 655-4111
(859) 655-4815

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116029002
VA
207Q00000X
Family Medicine Physician
Primary
52784
KY

Other

Enumeration date
06/15/2016
Last updated
05/09/2022
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