MEDICARE: DR. MELISSA KHALIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician	ME161445	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346877289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA KHALIL MD

Provider Business Mailing Address
First Line	:	99 VETERANS WAY BLDG 160
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-5470
Country	:	US
Telephone Number	:	423-926-1171
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 VETERANS WAY BLDG 160
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-5470
Country	:	US
Telephone Number	:	423-926-1171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	05/28/2025

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