MEDICARE: MRS. MICHELLE MEREDITH AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	A01502	OH

General Provider Information

NPI Number	:	1013189380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE MEREDITH AU.D.

Provider Business Mailing Address
First Line	:	2212 MIFFLIN AVE
Second Line	:	SUITE 130
City	:	ASHLAND
State	:	OH
Zip	:	44805-8846
Country	:	US
Telephone Number	:	419-289-8919
Fax Number	:	419-289-9563

Provider Business Practice Location Address
First Line	:	2212 MIFFLIN AVE
Second Line	:	SUITE 130
City	:	ASHLAND
State	:	OH
Zip	:	44805-8846
Country	:	US
Telephone Number	:	419-289-8919
Fax Number	:	419-289-9563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	03/27/2008

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