Individual
ROBERT L MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-8180
(920) 431-3245
Mailing address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-8180
(920) 431-3245
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
34542
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104455742
MICHIGAN MED ASSISTANCE
MI
05
—
32422700
—
WI
01
—
360004256
RAILROAD MEDICARE
WI
Enumeration date
06/12/2006
Last updated
08/13/2008
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