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Individual

MR. TERRY MERIDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD FACP FACN FACE

Contact information

Practice address
900 MAIN STREET, SUITE 300, PEORIA, IL 61602
(309) 673-1717
(309) 673-7221
Mailing address
900 MAIN STREET, SUITE 300, PEORIA, IL 61602
(309) 673-1717
(309) 673-7221

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0360586021
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036058602
IL
01
792111124
RAILROAD MEDICARE
01
9000138
BCBS
IL
Enumeration date
10/27/2006
Last updated
03/13/2013
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