Provider Demographics
NPI:1578603916
Name:WORKMAN, MEREDITH CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CHRISTINE
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 S DOBSON RD STE 401
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4777
Mailing Address - Country:US
Mailing Address - Phone:480-658-0123
Mailing Address - Fax:480-383-6429
Practice Address - Street 1:1432 S DOBSON RD STE 401
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4777
Practice Address - Country:US
Practice Address - Phone:480-658-0123
Practice Address - Fax:480-383-6429
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46382208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ711148Medicaid