Healthcare Provider Details

I. General information

NPI: 1033274972
Provider Name (Legal Business Name): MELISSA HAMP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BLACKFORD STREET
CHATTANOOGA TN
37403-1405
US

IV. Provider business mailing address

PO BOX 11503
CHATTANOOGA TN
37401-2503
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-6107
  • Fax: 423-778-6020
Mailing address:
  • Phone: 423-778-3274
  • Fax: 423-778-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301053465
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4301053465
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number46631
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number46631
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: