Provider Demographics
NPI:1518943851
Name:MEDING, JOHN B (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:MEDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W BUNKERHILL RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-6824
Mailing Address - Country:US
Mailing Address - Phone:317-831-2273
Mailing Address - Fax:
Practice Address - Street 1:1801 W BUNKERHILL RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-6824
Practice Address - Country:US
Practice Address - Phone:317-831-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039789207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN006761OtherSIHO
IN100376470Medicaid
IN8182830003OtherCIGNA
IN000000188556OtherBCBS
IN200040491OtherRRMC
IN4487435OtherAETNA
IN1912596OtherUHC
IN1912596OtherUHC
IN177100AMedicare ID - Type Unspecified