Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 12013506A | IN |
N | 1223D0001X | Dental Public Health | 2901022754 | MI |
NPI | 1699261305 |
---|---|
Provider Name | Dr. Kamani Meriwether |
First Address | Goshen, IN 46528-7100 |
Second Address | Goshen, IN 46528-7100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2018 |
Last Update Date | 12/02/2021 |