Organization
MERIDIAN INDEPENDENT PHYSICIAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ALEXANDER (OWNER)
(540) 845-9499
Entity
Organization
Contact information
Practice address
7 PLANTERS PL, STAFFORD, VA 22554-8507
(540) 845-9499
Mailing address
7 PLANTERS PL, STAFFORD, VA 22554-8507
(540) 845-9499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336538222
ANTHEM
VA
05
—
1336538222
—
VA
01
—
E455
MEDICAREPTAN
VA
Enumeration date
01/14/2015
Last updated
04/25/2015
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