Individual
TARA M MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002436
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016132M68
MEDICARE
—
01
—
1336208693
TRICARE
—
05
—
1336208693
—
VA
01
—
P00458958
MEDICARE RAILROAD CARRIER
VA
Enumeration date
12/06/2006
Last updated
01/12/2023
Update your record
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