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General NPI Number Information
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NPI Number | 1053109884
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY MEINHOLD EPC
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Gender | Male
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 773 WALKER RD
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City | DOVER
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State | DE
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Zip | 19904-2753
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Country | US
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Telephone | 302-359-1890
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Fax |
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Provider Business Mailing Address
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Address Line | 773 WALKER RD
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City | DOVER
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State | DE
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Zip | 19904-2753
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Country | US
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Telephone | 302-359-1890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 394
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License Number State | DE
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