Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301053465 | MI |
Y | 208000000X | Pediatrician | 46631 | TN |
N | 2080A0000X | Adolescent Medicine | 4301053465 | MI |
N | 2080A0000X | Adolescent Medicine | 46631 | TN |
NPI | 1033274972 |
---|---|
Provider Name | Melissa Hamp |
First Address | Chattanooga, TN 37401-2503 |
Second Address | Chattanooga, TN 37403-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 22/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C34113 | (02) |