Provider Demographics
NPI:1154424398
Name:HATZIS, MELANIE TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:TAYLOR
Last Name:HATZIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NNPTC CIR
Mailing Address - Street 2:GC VA CLINIC
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445
Mailing Address - Country:US
Mailing Address - Phone:843-577-5011
Mailing Address - Fax:843-724-3051
Practice Address - Street 1:110 NNPTC CIR
Practice Address - Street 2:GC VA CLINIC
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445
Practice Address - Country:US
Practice Address - Phone:843-577-5011
Practice Address - Fax:843-724-3051
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC239552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry