Provider Demographics
NPI:1033735287
Name:RIDEOUT, MEREDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:
Last Name:RIDEOUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-1927
Mailing Address - Country:US
Mailing Address - Phone:908-847-3357
Mailing Address - Fax:908-847-2889
Practice Address - Street 1:34 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1927
Practice Address - Country:US
Practice Address - Phone:908-847-3357
Practice Address - Fax:908-847-2889
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT221863390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program