Organization
MERIDIAN MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN A WALTER (ADMINISTRATOR)
(317) 962-5870
Entity
Organization
Contact information
Practice address
1115 N RONALD REAGAN PKWY, SUITE 347, AVON, IN 46123
(317) 217-2111
(317) 217-2110
Mailing address
1801 N SENATE BLVD, SUITE 400, INDIANAPOLIS, IN 46202
(317) 962-6300
(317) 962-2346
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
050037961
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100380420B
—
IN
Enumeration date
05/05/2006
Last updated
09/23/2008
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