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General NPI Number Information
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NPI Number | 1447587910
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Entity Type | Organization
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Legal Business Name | MERIDIAN OBSTETRICS AND GYNECOLOGY PC
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY SUITE 220
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City | ATLANTA
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 404-250-3660
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Fax | 404-250-3665
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Provider Business Mailing Address
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Address Line | PO BOX 922937
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City | NORCROSS
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State | GA
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Zip | 30010-2937
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Country | US
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Telephone | 404-250-3660
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Fax | 404-250-3665
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Authorized Official
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Title or Position | OWNER
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Name | DR. VALISIA A ANDREWS
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Credential | MD
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Telephone | 404-250-3660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 046291
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License Number State | GA
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