Basic Information
Provider Information
NPI: 1609974708
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESTER
FirstName: MELISSA
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1249 15TH ST
Address2: 4000
City: HUNTINGTON
State: WV
PostalCode: 257013662
CountryCode: US
TelephoneNumber: 3046918500
FaxNumber: 3046918510
Practice Location
Address1: 1249 15TH ST
Address2: 4000
City: HUNTINGTON
State: WV
PostalCode: 257013662
CountryCode: US
TelephoneNumber: 3046918500
FaxNumber: 3046918510
Other Information
ProviderEnumerationDate: 09/20/2006
LastUpdateDate: 11/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X1944WVN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X1944WVN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X1944WVY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
381000227005WV MEDICAID


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