Healthcare Provider Details

I. General information

NPI: 1215322102
Provider Name (Legal Business Name): MEREDITH HARRIS M.D. MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 5018
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE DEPT OF
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 194-410-2410
  • Fax:
Mailing address:
  • Phone: 194-410-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number036.156162
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: