Healthcare Provider Details

I. General information

NPI: 1942514310
Provider Name (Legal Business Name): RYAN MEREDITH, AU.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 STEWART RD
MONROE MI
48162-4393
US

IV. Provider business mailing address

321 STEWART RD
MONROE MI
48162-4393
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-5020
  • Fax: 734-457-1970
Mailing address:
  • Phone: 734-243-5020
  • Fax: 734-457-1970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000432
License Number StateMI

VIII. Authorized Official

Name: DR. RYAN L MEREDITH
Title or Position: DOCTOR OF AUDIOLOGY/OWNER
Credential: AU.D.
Phone: 734-243-5020