Individual
MELANIE BLACK BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1008 EXECUTIVE DR STE 104, HIXSON, TN 37343-3992
(423) 497-5363
Mailing address
532 FERN TRL, SIGNAL MOUNTAIN, TN 37377-3167
(205) 999-0232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44821
TN
Other
Enumeration date
05/03/2007
Last updated
06/30/2023
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