Individual
MELISSA MILLER KOUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
ONE HOSPITAL DRIVE, COLUMBIA, MO 65212-0001
(573) 884-9066
(573) 884-3037
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001009493
MO
2080A0000X
Pediatric Adolescent Medicine Physician
2001009493
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147494
BLUESHIELD/BLUE CHOICE
MO
05
—
205363906
—
MO
01
—
405522
UNITED HEALTHCARE
MO
01
—
464041
HEALTHLINK
MO
Enumeration date
07/05/2006
Last updated
03/11/2013
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