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General NPI Number Information
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NPI Number | 1689615791
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Entity Type | Individual
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Provider Name | WENDY SUE MEREDITH PA C
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/08/2020
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Provider Practice Location Address
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Address Line | 2303 STONE BRIDGE DRIVE
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City | FLINT
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State | MI
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Zip | 48532-5407
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Country | US
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Telephone | 810-733-8041
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Fax | 810-733-0926
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Provider Business Mailing Address
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Address Line | 2256 W HILL RD
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City | FLINT
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State | MI
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Zip | 48507-4655
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Country | US
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Telephone | 810-733-8041
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Fax | 810-733-0926
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601002983
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License Number State | MI
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