Provider Demographics
NPI:1649854787
Name:MEDDING, WILLIAM LANDON
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LANDON
Last Name:MEDDING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 N ADAMS AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-1786
Mailing Address - Country:US
Mailing Address - Phone:443-722-6678
Mailing Address - Fax:
Practice Address - Street 1:389 N ADAMS AVE APT 5
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-1786
Practice Address - Country:US
Practice Address - Phone:443-722-6678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management