Provider Demographics
NPI:1881823326
Name:PRENGER, MEREDITH LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LEIGH
Last Name:PRENGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:LEIGH
Other - Last Name:BARFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 LOONEY RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-4199
Mailing Address - Country:US
Mailing Address - Phone:937-440-8687
Mailing Address - Fax:937-773-8058
Practice Address - Street 1:280 LOONEY RD
Practice Address - Street 2:STE 101
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4199
Practice Address - Country:US
Practice Address - Phone:937-440-8687
Practice Address - Fax:937-773-8058
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098379208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0061031Medicaid
OHH147371Medicare PIN
OH0061031Medicaid