Provider Demographics
NPI:1891907549
Name:GRAVES, MELISSA DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:DAWN
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:LOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:167 S MINERAL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2643
Mailing Address - Country:US
Mailing Address - Phone:304-597-2494
Mailing Address - Fax:304-597-2497
Practice Address - Street 1:167 S MINERAL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2643
Practice Address - Country:US
Practice Address - Phone:304-597-2494
Practice Address - Fax:304-597-2497
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine