Provider Demographics
NPI:1598057317
Name:WHITACRE, MEREDITH LAINE (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LAINE
Last Name:WHITACRE
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 1:2301 ERWIN RD # DUMC3094
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4699
Mailing Address - Country:US
Mailing Address - Phone:919-681-3551
Mailing Address - Fax:919-681-1619
Practice Address - Street 1:2301 ERWIN RD # DUMC3094
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-681-3551
Practice Address - Fax:919-681-1619
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC173583390200000X
NC2013-01970207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program