Healthcare Provider Details

I. General information

NPI: 1831509868
Provider Name (Legal Business Name): MEREDITH K GREER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EXECUTIVE PARK DR NE
ATLANTA GA
30329-2206
US

IV. Provider business mailing address

12 EXECUTIVE PARK DR NE FL 4
ATLANTA GA
30329-2206
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-7533
  • Fax:
Mailing address:
  • Phone: 404-712-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number80294
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number80294
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number80294
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: