Provider Demographics
NPI:1720835960
Name:BREHM, MEREDITH LOUISE
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LOUISE
Last Name:BREHM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CATAWBA CIR N
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-5126
Mailing Address - Country:US
Mailing Address - Phone:317-833-5546
Mailing Address - Fax:
Practice Address - Street 1:609 CATAWBA CIR N
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-5126
Practice Address - Country:US
Practice Address - Phone:317-833-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant