MEDICARE: CHRISTINE MEASHAM M.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	207ZD0900X	Dermatopathology (Pathology) Physician	M8951	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558321323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MEASHAM M.D.

Provider Business Mailing Address
First Line	:	1618 S MILLENIUM WAY STE 100
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6457
Country	:	US
Telephone Number	:	208-884-3376
Fax Number	:	208-884-0858

Provider Business Practice Location Address
First Line	:	1618 S MILLENIUM WAY
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6439
Country	:	US
Telephone Number	:	208-377-1969
Fax Number	:

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	06/04/2025

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