Provider Demographics
NPI:1710147319
Name:SIMPSON-MEEK, MALEAH DEAN (PA)
Entity Type:Individual
Prefix:
First Name:MALEAH
Middle Name:DEAN
Last Name:SIMPSON-MEEK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1423 E FRANKLIN ST
Practice Address - Street 2:STE D
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5266
Practice Address - Country:US
Practice Address - Phone:704-289-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1710147319Medicaid
SC0841PAMedicaid
SC0841PAMedicaid
NCNC9440AMedicare PIN