Organization
HAVEN EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY R. MEADOWS MD (VICE PRESIDENT)
(800) 507-8874
Entity
Organization
Contact information
Practice address
11375 CORTEZ BLVD, SPRING HILL, FL 34613-5409
(352) 596-6632
Mailing address
PO BOX 13943, PHILADELPHIA, PA 19101-3943
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21848
BLUE SHIELD
FL
05
—
254691400
—
FL
Enumeration date
05/09/2006
Last updated
03/30/2011
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