Individual
MRS. MELANIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
41100 PLYMOUTH RD STE 110, PLYMOUTH, MI 48170-3895
(734) 715-1907
(734) 715-1908
Mailing address
41100 PLYMOUTH RD STE B1-162, PLYMOUTH, MI 48170-3799
(734) 715-1907
(734) 715-1908
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010239
MI
Other
Enumeration date
02/10/2020
Last updated
04/17/2026
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