Individual
MR. MEATERAN A FUNWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13121 BROOK LN, 13121 BROOK LN, HAGERSTOWN, MD 21742
(301) 733-0330
Mailing address
17498 IRISHTOWN RD, EMMITSBURG, MD 21727-9275
(301) 401-0196
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP500007332
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R238827.
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407522451
—
MD
Enumeration date
08/19/2021
Last updated
11/02/2023
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