Provider Demographics
NPI:1821307760
Name:TREECE, MEREDITH CAMERON (OD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:CAMERON
Last Name:TREECE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:CAMERON
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5526B CAROLINA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2606
Mailing Address - Country:US
Mailing Address - Phone:910-452-7225
Mailing Address - Fax:910-452-7229
Practice Address - Street 1:5526B CAROLINA BEACH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2606
Practice Address - Country:US
Practice Address - Phone:910-452-7225
Practice Address - Fax:910-452-7229
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2190152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916591Medicaid
NC5916591Medicaid
NCNC2970C699Medicare PIN