Provider Demographics
NPI:1235105883
Name:MEADOWS, DEBORAH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MEADOWS
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 1:135 COMMONWEALTH DR
Mailing Address - Street 2:STE 170
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4831
Mailing Address - Country:US
Mailing Address - Phone:864-297-0080
Mailing Address - Fax:864-297-4588
Practice Address - Street 1:135 COMMONWEALTH DR
Practice Address - Street 2:STE 170
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4831
Practice Address - Country:US
Practice Address - Phone:864-297-0080
Practice Address - Fax:864-297-4588
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9937207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4283784OtherAETNA
SC3203970OtherCAROLINA CARE PLAN
SC099379Medicaid
SC099379Medicaid
4283784OtherAETNA