Provider Demographics
NPI:1558334417
Name:NATHAN, MEERA V (MD)
Entity Type:Individual
Prefix:DR
First Name:MEERA
Middle Name:V
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 PENN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19144
Mailing Address - Country:US
Mailing Address - Phone:215-842-0406
Mailing Address - Fax:215-842-3215
Practice Address - Street 1:2 PENN BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19144-1416
Practice Address - Country:US
Practice Address - Phone:215-842-0406
Practice Address - Fax:215-842-3215
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD031716-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE66683Medicare UPIN