Provider Demographics
NPI:1083024400
Name:MERITRA CLINICS LLC
Entity Type:Organization
Organization Name:MERITRA CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEKKAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-727-4612
Mailing Address - Street 1:109 COMMERCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8349
Mailing Address - Country:US
Mailing Address - Phone:614-882-9355
Mailing Address - Fax:614-882-9576
Practice Address - Street 1:109 COMMERCE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8349
Practice Address - Country:US
Practice Address - Phone:614-882-9355
Practice Address - Fax:614-882-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty