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General NPI Number Information
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NPI Number | 1912234683
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Entity Type | Organization
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Legal Business Name | MERIDIAN INTERNAL MEDICINE, P.A.
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 306 N COX ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5528
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Country | US
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Telephone | 336-633-3073
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Fax | 336-633-3074
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Provider Business Mailing Address
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Address Line | PO BOX 4937
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City | ASHEBORO
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State | NC
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Zip | 27204-4937
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Country | US
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Telephone | 336-633-3073
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Fax | 336-633-3074
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CAROLINE C PROCHNAU
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Credential | M.D.
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Telephone | 336-633-3073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2000-01522
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License Number State | NC
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