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Individual

AUGUSTUS E MEALOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
979 E 3RD ST STE C-520, CHATTANOOGA, TN 37403-2136
(423) 778-5661
(423) 778-5664
Mailing address
975 E. THIRD STREET - ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-0388
(423) 778-5661
(423) 778-5664

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
55732
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
55732
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55732
MEDICAL LICENSE
TN
Enumeration date
06/06/2008
Last updated
07/21/2022
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