Provider Demographics
NPI:1184913477
Name:MEZA, ANASTACIO S
Entity type:Individual
Prefix:MR
First Name:ANASTACIO
Middle Name:S
Last Name:MEZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50527
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-0527
Mailing Address - Country:US
Mailing Address - Phone:317-363-6827
Mailing Address - Fax:317-641-3913
Practice Address - Street 1:8433 HARRION DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-2034
Practice Address - Country:US
Practice Address - Phone:317-363-6827
Practice Address - Fax:317-641-3913
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy