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Individual

MRS. MELISSA PECKO SHULEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2415 MCCALLIE AVE, CHATTANOOGA, TN 37404-3322
(423) 624-2696
(423) 697-2059
Mailing address
2415 MCCALLIE AVE, CHATTANOOGA, TN 37404-3322
(423) 624-2696
(423) 697-2059

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1830
TN
363AM0700X
Medical Physician Assistant
PA-626
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518643
TN
01
4256870
BCBSTN
TN
Enumeration date
03/16/2009
Last updated
01/10/2012
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