Individual
DR. MICHAEL C MENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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