Provider Demographics
NPI:1467585521
Name:MEADOWS, AUDRA R (MD, MPH)
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:R
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:AUDRA
Other - Middle Name:D
Other - Last Name:ROBERSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BWH OB/GYN ASB-I-3-073
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-525-9344
Practice Address - Fax:617-975-0966
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218451207V00000X
CAC171680207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology