Healthcare Provider Details

I. General information

NPI: 1700238920
Provider Name (Legal Business Name): MELISSA YEN YEN MOEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 HEART DR
GREENVILLE NC
27834-8982
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4400
  • Fax: 252-744-3987
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number2024-02064
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2024-02064
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: