Organization
CLOVER EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY R MEADOWS (VICE PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
2323 9TH AVE N, ST PETERSBURG, FL 33713-6832
(727) 326-6185
Mailing address
13737 NOEL RD, DALLAS, TX 75240-1331
(469) 401-2386
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21794
BLUE SHIELD
FL
05
—
254689200
—
FL
Enumeration date
05/08/2006
Last updated
12/22/2013
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