Provider Demographics
NPI:1457356784
Name:PLATT, MELISSA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:PLATT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:530 S JACKSON ST
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE C1H17
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1675
Mailing Address - Country:US
Mailing Address - Phone:502-852-5689
Mailing Address - Fax:502-852-4701
Practice Address - Street 1:530 S JACKSON ST
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE C1H17
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1675
Practice Address - Country:US
Practice Address - Phone:502-852-5689
Practice Address - Fax:502-852-4701
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2015-06-01
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Provider Licenses
StateLicense IDTaxonomies
KY38698207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000060614OtherBCBS OF KY 12 DIGIT NUMBE
KY64069537Medicaid
FL64069537OtherPASSPORT GROUP #1172544
KY50004901OtherPASSPORT GROUP # 50000548
KY000000060614OtherBCBS OF KY 12 DIGIT NUMBE
FL64069537OtherPASSPORT GROUP #1172544
KY0217322Medicare ID - Type Unspecified
KY0754610Medicare ID - Type UnspecifiedMEDICARE GROUP # 7546