Provider Demographics
NPI:1518737113
Name:MELVIN, SHAMIEKA (CHES)
Entity Type:Individual
Prefix:MRS
First Name:SHAMIEKA
Middle Name:
Last Name:MELVIN
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:MRS
Other - First Name:SHAMIEKA
Other - Middle Name:MELVIN
Other - Last Name:CLOTTEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHES
Mailing Address - Street 1:290 ARBORVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-2989
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 ARBORVIEW DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-2989
Practice Address - Country:US
Practice Address - Phone:678-549-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator