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NPI Code Detail

MEDICARE: MELISSA DAWN KITZMILLER MD

MEDICARE: MELISSA DAWN KITZMILLER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician20333WV
2207Q00000XFamily Medicine Physician20333WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11659329761OTHERNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659329761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA DAWN KITZMILLER MD
Provider Business Mailing Address
First Line : 22347 NORTHWESTERN PIKE
Second Line :
City : ROMNEY
State : WV
Zip : 26757-6343
Country : US
Telephone Number : 304-822-3838
Fax Number : 304-822-7665
Provider Business Practice Location Address
First Line : 422S MAIN ST
Second Line :
City : MOOREFIELD
State : WV
Zip : 26836-1238
Country : US
Telephone Number : 304-538-2331
Fax Number : 304-538-2663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 10/13/2015

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