Provider Demographics
NPI:1952370751
Name:MEKO, CHRISTIAN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JAMES
Last Name:MEKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11050 MT BELVEDERE BLVD
Mailing Address - Street 2:FORT DRUM MEDDAC
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602
Mailing Address - Country:US
Mailing Address - Phone:315-774-2643
Mailing Address - Fax:315-774-2639
Practice Address - Street 1:11050 MOUNT BELVEDERE BLVD
Practice Address - Street 2:FORT DRUM MEDDAC
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602-5438
Practice Address - Country:US
Practice Address - Phone:315-774-2643
Practice Address - Fax:315-774-2639
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101236199207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine