MEDICARE: DR. SHAWN R MEADER 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	2085R0202X	Diagnostic Radiology Physician	ME91365	FL
2	2085R0204X	Vascular & Interventional Radiology Physician	ME91365	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780655134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN R MEADER MD

Provider Business Mailing Address
First Line	:	2700 UNIVERSITY SQUARE DR
Second Line	:	RADIOLOGY ASSOCIATES OF TAMPA
City	:	TAMPA
State	:	FL
Zip	:	33612-5513
Country	:	US
Telephone Number	:	813-251-5822
Fax Number	:	813-254-4597

Provider Business Practice Location Address
First Line	:	2700 UNIVERSITY SQUARE DR
Second Line	:	RADIOLOGY ASSOCIATES OF TAMPA
City	:	TAMPA
State	:	FL
Zip	:	33612-5513
Country	:	US
Telephone Number	:	813-251-5822
Fax Number	:	813-254-4597

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/31/2021

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