MEDICARE: BEN MILLER MEARES JR. MD

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	208000000X	Pediatrics Physician	2002-00413	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1314A	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134158280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEN MILLER MEARES JR. MD

Provider Business Mailing Address
First Line	:	3100 DURALEIGH RD
Second Line	:	STE 300
City	:	RALEIGH
State	:	NC
Zip	:	27612-8104
Country	:	US
Telephone Number	:	919-781-7490
Fax Number	:	919-783-0903

Provider Business Practice Location Address
First Line	:	2800 BLUE RIDGE RD
Second Line	:	SUITE 401
City	:	RALEIGH
State	:	NC
Zip	:	27607-6478
Country	:	US
Telephone Number	:	919-781-7490
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	06/13/2018

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