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General NPI Number Information
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NPI Number | 1245443423
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Entity Type | Organization
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Legal Business Name | MERIDIAN GYNECOLOGICAL CENTER
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 1205 HADLEY RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-1737
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Country | US
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Telephone | 317-831-9439
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Fax | 317-834-5928
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Provider Business Mailing Address
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Address Line | 1205 HADLEY RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-1737
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Country | US
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Telephone | 317-831-9439
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Fax | 317-834-5928
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Authorized Official
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Title or Position | OWNER
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Name | G. ALAN VON STEIN, M.D.
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Credential | M.D.
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Telephone | 317-831-9469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 01040116A
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License Number State | IN
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