Provider Demographics
NPI:1952912891
Name:MELEK, MINA BASSEM (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINA
Middle Name:BASSEM
Last Name:MELEK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 MURFREESBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1503
Mailing Address - Country:US
Mailing Address - Phone:615-360-6401
Mailing Address - Fax:
Practice Address - Street 1:1081 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1503
Practice Address - Country:US
Practice Address - Phone:615-360-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist