Provider Demographics
NPI:1447419569
Name:WALEH, MESHIA Q (MD)
Entity Type:Individual
Prefix:
First Name:MESHIA
Middle Name:Q
Last Name:WALEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3209 COLONIAL DRIVE
Mailing Address - Street 2:UNIVERSITY SPECIALTY CLINICS-FAMILY & PREVENTIVE MEDICI
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6930
Mailing Address - Country:US
Mailing Address - Phone:803-434-6113
Mailing Address - Fax:803-434-7231
Practice Address - Street 1:3209 COLONIAL DRIVE
Practice Address - Street 2:UNIVERSITY SPECIALTY CLINICS-FAMILY & PREVENTIVE MEDICI
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6930
Practice Address - Country:US
Practice Address - Phone:803-434-6113
Practice Address - Fax:803-434-7231
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00922207Q00000X
SC35077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC350774Medicaid
SCAA94632353OtherMEDICARE PTAN
SC2353GROUPMedicare PIN