Individual
DR. DESPINA MELISSA POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3200 MACCORKLE AVE SE, HOSPITALISTS PROGRAM, CHARLESTON, WV 25304-1227
(304) 388-5848
(304) 388-9654
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24286
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/25/2007
Last updated
05/11/2011
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