Provider Demographics
NPI:1407952302
Name:WELLS, MEERA (MD)
Entity Type:Individual
Prefix:DR
First Name:MEERA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEERA
Other - Middle Name:
Other - Last Name:KODIYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:19 DAVIS AVE
Mailing Address - Street 2:FL 9
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4488
Mailing Address - Country:US
Mailing Address - Phone:443-256-3818
Mailing Address - Fax:443-252-8084
Practice Address - Street 1:210 MARLBORO AVE # 394
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2765
Practice Address - Country:US
Practice Address - Phone:443-256-3818
Practice Address - Fax:443-252-8084
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00634782084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD083939600Medicaid
MD083939600Medicaid