Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2010-00046 | NC |
N | 111NI0900X | Internist | 2010-00046 | NC |
Y | 207RR0500X | Rheumatology | 35121043 | OH |
NPI | 1063670693 |
---|---|
Provider Name | Dr. Alexa Simon Meara |
First Address | Columbus, OH 43203-1278 |
Second Address | Columbus, OH 43203-1278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 04/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1580T | BCBSNC (01) | NC |
5917261 | (05) | NC |
PENDING | (05) | OH |