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NPI Code Detail

MEDICARE: MELISSA LONDON TEAGUE

MEDICARE: MELISSA LONDON TEAGUE
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
11041C0700XClinical Social WorkerC005745NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1148FWOTHERNCBCBSNC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619176773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA LONDON TEAGUE
Provider Business Mailing Address
First Line : 420 N CENTER ST
Second Line :
City : HICKORY
State : NC
Zip : 28601-5033
Country : US
Telephone Number : 828-315-5092
Fax Number :
Provider Business Practice Location Address
First Line : 420 N CENTER ST
Second Line :
City : HICKORY
State : NC
Zip : 28601-5033
Country : US
Telephone Number : 828-315-5092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2007
Last Update Date : 07/02/2012

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Directions to “ MELISSA LONDON TEAGUE ” Practice Location

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