Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MD445739 | PA |
NPI | 1205900479 |
---|---|
Provider Name | Dr. Kent Alexander Meldrum |
First Address | Lancaster, PA 17601-2433 |
Second Address | Lancaster, PA 17601-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 16/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102740024 | (05) | PA |