Organization
MERIDIAN ADULT MEDICINE, PLLC
Active
Organization
MERIDIAN ADULT MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS MICHAEL SCHLICKMAN M.D. (OWNER)
(208) 884-3770
Entity
Organization
Contact information
Practice address
520 S EAGLE RD, SUITE 1221, MERIDIAN, ID 83642-6351
(208) 884-3770
(208) 884-5602
Mailing address
520 S EAGLE RD, SUITE 1221, MERIDIAN, ID 83642-6351
(208) 884-3770
(208) 884-5602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7522
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8J810
BLUE CROSS GROUP
ID
01
—
DC8105
RAILROAD MEDICARE GROUP
ID
Enumeration date
05/19/2006
Last updated
07/12/2007
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