Healthcare Provider Details

I. General information

NPI: 1376655613
Provider Name (Legal Business Name): MERIDIAN SURGICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13430 N MERIDIAN ST SUITE 275
CARMEL IN
46032-1405
US

IV. Provider business mailing address

13430 N MERIDIAN ST SUITE 275
CARMEL IN
46032-1405
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-8810
  • Fax: 317-582-8852
Mailing address:
  • Phone: 317-582-8810
  • Fax: 317-582-8852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. COLLEEN RENEE OBRIEN
Title or Position: OFFICE MANAGER
Credential:
Phone: 317-582-8810