Provider Demographics
NPI:1508843970
Name:MEIRELLES, EDUARDO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:MEIRELLES
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N. 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-834-7050
Mailing Address - Fax:509-834-7051
Practice Address - Street 1:1110 N. 35TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-834-7050
Practice Address - Fax:509-834-7051
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047704207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8864666Medicare PIN
I38858Medicare UPIN
WA8476780Medicaid