Healthcare Provider Details

I. General information

NPI: 1497723944
Provider Name (Legal Business Name): MEREDITH H RAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 W STREET RD
FEASTERVILLE TREVOSE PA
19053-7817
US

IV. Provider business mailing address

14B MEMORIAL DRIVE
DOYLESTOWN PA
18901
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-6490
  • Fax:
Mailing address:
  • Phone: 215-348-4914
  • Fax: 215-230-3664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA77401
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD422642
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: