1457356081 NPI number — STEVE R MEADOWS MD

Table of content: STEVE R MEADOWS MD (NPI 1457356081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457356081 NPI number — STEVE R MEADOWS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEADOWS
Provider First Name:
STEVE
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457356081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21375 LORAIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRVIEW PARK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44126-2122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-333-7346
Provider Business Mailing Address Fax Number:
440-333-0273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21375 LORAIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRVIEW PARK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44126-2122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-333-7346
Provider Business Practice Location Address Fax Number:
440-333-0273
Provider Enumeration Date:
06/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  35083115 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 341311807 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1382523 . This is a "UMWA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0826931 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 368590 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: F86115 . This is a "APEX / ANTARAS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7391716 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P00235512 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".