Provider Demographics
NPI:1184924268
Name:MESHEL CARDIOLOGY PC
Entity type:Organization
Organization Name:MESHEL CARDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:C
Authorized Official - Last Name:MESHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-970-9191
Mailing Address - Street 1:10 WESTWOOD MEDICAL PARK
Mailing Address - Street 2:PO BOX 969
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2000
Mailing Address - Country:US
Mailing Address - Phone:276-326-1995
Mailing Address - Fax:276-326-1996
Practice Address - Street 1:10 WESTWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2000
Practice Address - Country:US
Practice Address - Phone:276-326-1995
Practice Address - Fax:276-326-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-24
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232141207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010100224Medicaid
WV3810019297Medicaid
WV3810019297Medicaid
VA010100224Medicaid