Provider Demographics
NPI:1760933790
Name:MOHR, MEREDITH DYANN
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:DYANN
Last Name:MOHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-4003
Mailing Address - Country:US
Mailing Address - Phone:443-593-8283
Mailing Address - Fax:
Practice Address - Street 1:7 MAPLE CT
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4003
Practice Address - Country:US
Practice Address - Phone:443-593-8283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant