Provider Demographics
NPI:1902658875
Name:MOORE, MELANIE (DNA PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:DNA PHLEBOTOMIST
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2086 JODECO RD # 1571
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-5220
Mailing Address - Country:US
Mailing Address - Phone:912-710-3222
Mailing Address - Fax:
Practice Address - Street 1:2086 JODECO RD # 1571
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5220
Practice Address - Country:US
Practice Address - Phone:912-710-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No1744R1102XOther Service ProvidersSpecialistResearch Study