Provider Demographics
NPI:1003115502
Name:SKUPIN, MELISSA K (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:K
Last Name:SKUPIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9800 SHELBYVILLE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:502-429-8585
Mailing Address - Fax:502-429-6157
Practice Address - Street 1:5001 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-980-7180
Practice Address - Fax:502-429-6157
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2021-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.134300207K00000X
IN01080882A207K00000X
IL036141287207K00000X
KYTP837207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology