Provider Demographics
NPI:1124201066
Name:MECKES, ABIGAIL R (PA-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:R
Last Name:MECKES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:ROBARTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8094 SANDPIPER CIR STE O
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4907
Mailing Address - Country:US
Mailing Address - Phone:410-933-2214
Mailing Address - Fax:
Practice Address - Street 1:9101 FRANKLIN SQUARE DR STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3966
Practice Address - Country:US
Practice Address - Phone:443-777-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03678363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical