Individual
SUSANNA MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 HARRIS INDUSTRIAL BLVD, VIDALIA, GA 30474-8852
(912) 537-1014
(912) 538-1538
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
(912) 538-8166
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
62561
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087469741A
—
GA
Enumeration date
12/19/2006
Last updated
08/28/2019
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