Provider Demographics
NPI:1386684868
Name:NORRIS, MERIDETH C (DO)
Entity Type:Individual
Prefix:DR
First Name:MERIDETH
Middle Name:C
Last Name:NORRIS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:58 PORTLAND RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6656
Mailing Address - Country:US
Mailing Address - Phone:207-604-5034
Mailing Address - Fax:207-604-5038
Practice Address - Street 1:58 PORTLAND RD
Practice Address - Street 2:SUITE 18
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6656
Practice Address - Country:US
Practice Address - Phone:207-604-5034
Practice Address - Fax:207-604-5038
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2015-03-10
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Provider Licenses
StateLicense IDTaxonomies
ME1813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME280670099Medicaid
MEE100136968OtherPTAN
MEE100136968OtherPTAN