Individual
MEREDITH R WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
57216
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P01021773
MCR RAILROAD MEDICARE
MN
Enumeration date
06/18/2008
Last updated
11/01/2021
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