Provider Demographics
NPI:1609951318
Name:TWIEST, MELVIN WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:WAYNE
Last Name:TWIEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 FERN TRL
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-3167
Mailing Address - Country:US
Mailing Address - Phone:423-886-6391
Mailing Address - Fax:
Practice Address - Street 1:502 FERN TRL
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-3167
Practice Address - Country:US
Practice Address - Phone:423-886-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000035525208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery