Organization
PHILIP D MEADOR JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP DALE MEADOR JR. MD (PHYSICIAN)
(252) 492-2123
Entity
Organization
Contact information
Practice address
568 RUIN CREEK RD, SUITE 120, HENDERSON, NC 27536-2880
(252) 492-2123
(252) 436-0031
Mailing address
568 RUIN CREEK RD, SUITE 120, HENDERSON, NC 27536-2880
(252) 492-2123
(252) 436-0031
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17395
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58290
BCBSNC
NC
05
—
8958290
—
NC
Enumeration date
06/01/2007
Last updated
02/04/2011
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