Individual
ALEXIS DANIELLE MERIWEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
720 ESKENAZI AVENUE, FIFTH THIRD BANK BUILDING 3RD FLOOR, INDIANPOLIS, IN 46202
(317) 880-3900
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01084277A
IN
207P00000X
Emergency Medicine Physician
1083102206
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200369460F
—
IN
01
—
264430A002
MEDICARE PTAN
IN
05
—
300014445
—
IN
01
—
M120064007
MEDICARE PTAN
IN
Enumeration date
04/23/2018
Last updated
03/11/2024
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