Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | LDO000451 | GA |
NPI | 1033303086 |
---|---|
Provider Name | David Francis Meldrum |
First Address | Atlanta, GA 30309-1796 |
Second Address | Atlanta, GA 30309-1796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 04/09/2007 |