Provider Demographics
NPI:1689651168
Name:MURRAY, MELISSA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:MURRAY-BJORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-722-2862
Mailing Address - Fax:314-722-2852
Practice Address - Street 1:13303 TESSON FERRY RD STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-4099
Practice Address - Country:US
Practice Address - Phone:314-722-2862
Practice Address - Fax:314-722-2852
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000157495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205158009Medicaid
MO124510105Medicare PIN
H21181Medicare UPIN
MO332025682Medicare PIN