MEDICARE: DR. ROLF WALTER MEINHOLD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	029727	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08BBTFH	OTHER	GA	MEDICARE PROVIDER

General Provider Information

NPI Number	:	1649261686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROLF WALTER MEINHOLD MD

Provider Business Mailing Address
First Line	:	2702 ABBEY CT
Second Line	:	THE OFFICES@CRABAPPLE VILLAGE
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6024
Country	:	US
Telephone Number	:	770-772-9195
Fax Number	:	770-772-4088

Provider Business Practice Location Address
First Line	:	2702 ABBEY CT
Second Line	:	THE OFFICES@CRABAPPLE VILLAGE
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6024
Country	:	US
Telephone Number	:	770-772-9195
Fax Number	:	770-772-4088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	03/06/2014

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