Provider Demographics
NPI:1770808644
Name:NIESS, MEREDITH ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:ANNE
Last Name:NIESS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19485 OLD JETTON RD STE 100
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6583
Practice Address - Country:US
Practice Address - Phone:704-316-5170
Practice Address - Fax:704-316-5172
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO52385207R00000X
CT56376207R00000X
OR172772207R00000X
NC2019-01858207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine