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Individual

SAMUEL JOSEPH MEADEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
159 EXECUTIVE DR, SUITE C, DANVILLE, VA 24541-4160
(434) 792-0830
(434) 792-0468
Mailing address
159 EXECUTIVE DR, SUITE C, DANVILLE, VA 24541-4160
(434) 792-0830
(434) 792-0468

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101031594
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
032223
BCBS OF VA
VA
01
040000105
TRAILBLAZER HEALTH ENTERPRISES, LLC
VA
Enumeration date
05/24/2006
Last updated
10/10/2022
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