Individual
MEREDITH PORTALATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01072856A
IN
207RG0100X
Gastroenterology Physician
18685
PR
207RG0100X
Gastroenterology Physician
Primary
ME 117372
FL
208M00000X
Hospitalist Physician
MD.202377
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04330810
—
MS
05
—
1077747
—
LA
Enumeration date
08/01/2007
Last updated
02/23/2019
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