Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | R71523 | AZ |
Y | 207VE0102X | Reproductive Endocrinologist | 01076991A | IN |
NPI | 1073740957 |
---|---|
Provider Name | Dr. Meredith Price Provost |
First Address | Indianapolis, IN 46280-2000 |
Second Address | Indianapolis, IN 46280-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2009 |
Last Update Date | 05/09/2017 |