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General NPI Number Information
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NPI Number | 1487927265
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Entity Type | Organization
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Legal Business Name | TERRY I MERIDEN MD SC
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Dates
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Enumeration Date | 02/09/2012
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 900 MAIN ST SUITE 300
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City | PEORIA
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State | IL
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Zip | 61602-1005
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Country | US
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Telephone | 309-673-1717
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Fax | 309-673-7221
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Provider Business Mailing Address
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Address Line | 900 MAIN ST SUITE 300
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City | PEORIA
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State | IL
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Zip | 61602-1005
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Country | US
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Telephone | 309-673-1717
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Fax | 309-673-7221
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TERRY I MERIDEN
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Credential | MD FACP FACN FACE
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Telephone | 309-673-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 0360586021
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License Number State | IL
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