Healthcare Provider Details

I. General information

NPI: 1720467590
Provider Name (Legal Business Name): MEREDITH MARGARET MAXWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2852 REMINGTON GREEN CIR STE 101&102
TALLAHASSEE FL
32308-8710
US

IV. Provider business mailing address

8513 CASTLE PINE DRIVE
TALLAHASSEE FL
32312
US

V. Phone/Fax

Practice location:
  • Phone: 404-556-1293
  • Fax:
Mailing address:
  • Phone: 404-556-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number82883
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME17009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: