Individual
MARK P ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9702 CHESTNUT HILL LN, CHATTANOOGA, TN 37421-4815
(706) 226-5446
(866) 230-8698
Mailing address
208 WOODLAND AVE, CHATTANOOGA, TN 37405-3959
(706) 483-4999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036147
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00546532A
—
GA
Enumeration date
11/01/2006
Last updated
03/20/2023
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