Provider Demographics
NPI:1780655134
Name:MEADER, SHAWN R (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:R
Last Name:MEADER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 UNIVERSITY SQUARE DR
Mailing Address - Street 2:RADIOLOGY ASSOCIATES OF TAMPA
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5513
Mailing Address - Country:US
Mailing Address - Phone:813-251-5822
Mailing Address - Fax:813-254-4597
Practice Address - Street 1:2700 UNIVERSITY SQUARE DR
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF TAMPA
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5513
Practice Address - Country:US
Practice Address - Phone:813-251-5822
Practice Address - Fax:813-254-4597
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2021-03-31
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Provider Licenses
StateLicense IDTaxonomies
FLME913652085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270874400Medicaid
AL118775Medicaid
AL118775Medicaid
FL50008RMedicare PIN
FLP00625762Medicare PIN
FL50008Medicare PIN
FL270874400Medicaid
FL50008WMedicare PIN
FL50008MMedicare PIN
FL50008OMedicare PIN