Provider Demographics
NPI:1689845406
Name:MAXWELL, MEREDITH LEWIS (MD, MHA)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:LEWIS
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:STE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3628
Mailing Address - Country:US
Mailing Address - Phone:504-897-7197
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST STE 301
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3535
Practice Address - Country:US
Practice Address - Phone:504-897-8118
Practice Address - Fax:504-897-8466
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2126431Medicaid
LA2126431Medicaid