Healthcare Provider Details

I. General information

NPI: 1164487526
Provider Name (Legal Business Name): THOMAS STUART MELOY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 KIMEL FOREST DR SUITE 100
WINSTON SALEM NC
27103-6074
US

IV. Provider business mailing address

131 SAUNDERSVILLE RD SUITE 160
HENDERSONVILLE TN
37075-8903
US

V. Phone/Fax

Practice location:
  • Phone: 336-747-1800
  • Fax: 336-714-6402
Mailing address:
  • Phone: 615-824-3737
  • Fax: 855-540-4722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number37897
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number37897
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: