Provider Demographics
NPI:1841283272
Name:MEREDITH, TODD AARON (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:AARON
Last Name:MEREDITH
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 1:26484 CARRINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9114
Mailing Address - Country:US
Mailing Address - Phone:419-283-4497
Mailing Address - Fax:
Practice Address - Street 1:3028 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3308
Practice Address - Country:US
Practice Address - Phone:419-697-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079145M208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0826388Medicaid
OH26-3239286OtherBWC
OH35079145MOtherSTATE LICENSE
OH65124918300OtherBWC
2912415781OtherNRCME