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Individual

DR. MICHAEL C MENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2051 HAMILL RD, SUITE 403, HIXSON, TN 37343-6606
(423) 870-2063
(423) 870-2041
Mailing address
PO BOX 15628, CHATTANOOGA, TN 37415-0628
(423) 870-2063
(423) 870-2041

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000018148
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0080988
BLUE CROSS BLUE SHIELD
TN
05
3027219
TN
01
TN101
JOHN DEERE
TN
Enumeration date
06/28/2006
Last updated
03/06/2008
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