Provider Demographics
NPI:1063670693
Name:MEARA, ALEXA SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:SIMON
Last Name:MEARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:N
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-5066
Mailing Address - Fax:614-293-9449
Practice Address - Street 1:2050 KENNY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-5066
Practice Address - Fax:614-293-9449
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00046207R00000X
OH35121043207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917261Medicaid
NC1580TOtherBCBSNC
OHPENDINGMedicaid
NC5917261Medicaid
OHPENDINGMedicaid
OHPENDINGMedicare PIN