Provider Demographics
NPI:1467591073
Name:OUDT, MEREDITH L (DC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:OUDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2654 VALLEY AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2661
Mailing Address - Country:US
Mailing Address - Phone:540-678-0100
Mailing Address - Fax:540-678-1396
Practice Address - Street 1:2654 VALLEY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2661
Practice Address - Country:US
Practice Address - Phone:540-678-0100
Practice Address - Fax:540-678-1396
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005289A75Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE