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Individual
PHILLIP E MEEHAN
Active
Individual
PHILLIP E MEEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0571
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127834
MEDICA
SD
05
—
10025568900
—
NE
01
—
1609809094
ARAZ/ AMERICA'S PPO
SD
05
—
1821021304
—
IA
01
—
248340
MIDLAND'S CHOICE
SD
01
—
46L92ME
CC SYSTEMS/ BLUE PLUS
MN
01
—
4992676
BLUE CROSS
SD
01
—
57105AT04
WPS TRICARE
SD
05
—
6827152
—
SD
01
—
9238709
DAKOTACARE
SD
01
—
C83141041559
PREFERRED ONE
SD
Enumeration date
07/08/2006
Last updated
12/18/2013
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