Provider Demographics
NPI:1952657348
Name:MESHKINFAM, SAM (DO)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:MESHKINFAM
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2321 ATHERHOLT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2113
Mailing Address - Country:US
Mailing Address - Phone:434-947-3993
Mailing Address - Fax:434-947-3992
Practice Address - Street 1:2321 ATHERHOLT RD
Practice Address - Street 2:SUITE B
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2113
Practice Address - Country:US
Practice Address - Phone:434-947-3993
Practice Address - Fax:434-947-3992
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2024-01-17
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Provider Licenses
StateLicense IDTaxonomies
SC83765207Y00000X
VA0102203422207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540894959OtherTIN