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General NPI Number Information
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NPI Number | 1841392214
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Entity Type | Individual
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Provider Name | MERIWETHER MERSEREAU PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 4500 13TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-2515
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Country | US
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Telephone | 228-575-2126
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Fax |
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Provider Business Mailing Address
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Address Line | 1112A BOURBON ST
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City | NEW ORLEANS
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State | LA
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Zip | 70116-2710
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Country | US
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Telephone | 504-355-6113
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-010127
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License Number State | MS
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