Individual
CHARLES WAYNE MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 KELLER PARK BLVD, TUSCUMBIA, AL 35674-1417
(256) 381-6963
(256) 381-6018
Mailing address
234 KELLER PARK BLVD, TUSCUMBIA, AL 35674-1417
(256) 381-6963
(256) 381-6018
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10101
AL
208M00000X
Hospitalist Physician
10101
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009961925
—
AL
01
—
51522529
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/14/2005
Last updated
03/13/2023
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