Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 491004712 | MI |
NPI | 1013245273 |
---|---|
Provider Name | Dr. Patrick Michael Meade |
First Address | Vandenberg Afb, CA 93437-6307 |
Second Address | Vandenberg Afb, CA 93437-6307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2009 |
Last Update Date | 12/01/2022 |