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General NPI Number Information
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NPI Number | 1902884745
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Entity Type | Organization
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Legal Business Name | RICHARD T MEREDICK DPM PC
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 09/02/2008
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Provider Practice Location Address
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Address Line | 201 N MAIN AVE
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City | SCRANTON
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State | PA
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Zip | 18504-3303
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Country | US
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Telephone | 570-342-4009
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Fax | 570-342-4326
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Provider Business Mailing Address
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Address Line | 201 N MAIN AVE
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City | SCRANTON
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State | PA
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Zip | 18504-3303
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Country | US
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Telephone | 570-342-4009
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Fax | 570-342-4326
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD T MEREDICK
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Credential | DPM
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Telephone | 570-342-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC001634L
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License Number State | PA
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