Provider Demographics
NPI:1518943851
Name:MEDING, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:MEDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1199 HADLEY RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1788
Practice Address - Country:US
Practice Address - Phone:317-831-2273
Practice Address - Fax:317-831-9347
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2023-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01039789207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100376470Medicaid
IN4487435OtherAETNA
IN000000188556OtherBCBS
IN006761OtherSIHO
IN1912596OtherUHC
IN200040491OtherRRMC
IN8182830003OtherCIGNA
IN1912596OtherUHC
IN177100AMedicare ID - Type Unspecified