Provider Demographics
NPI:1023129517
Name:BEST, MEREDITH L (PAC)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:L
Last Name:BEST
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1847
Mailing Address - Country:US
Mailing Address - Phone:231-727-4444
Mailing Address - Fax:231-728-4789
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 324B
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-726-5075
Practice Address - Fax:231-728-1675
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004604363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1023129517Medicaid
MIMI1763042OtherMEDICARE PTAN