Provider Demographics
NPI:1801924550
Name:MEINHARDT, MILTON A (MD)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:A
Last Name:MEINHARDT
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 1:3777 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7695
Mailing Address - Country:US
Mailing Address - Phone:219-877-3826
Mailing Address - Fax:219-874-4776
Practice Address - Street 1:3777 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7695
Practice Address - Country:US
Practice Address - Phone:219-877-3826
Practice Address - Fax:219-874-4476
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060289A204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM