Healthcare Provider Details

I. General information

NPI: 1124415294
Provider Name (Legal Business Name): MEREDITH BEELER D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 RAVENSWOOD RD
HAMPSTEAD NC
28443-4022
US

IV. Provider business mailing address

7305 BALTIMORE AVE STE 107
COLLEGE PARK MD
20740-3232
US

V. Phone/Fax

Practice location:
  • Phone: 910-772-6558
  • Fax: 910-270-2290
Mailing address:
  • Phone: 301-864-2100
  • Fax: 301-864-5057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0085198
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: