Provider Demographics
NPI:1396887352
Name:SACHDEVA, MEERA (MD)
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:SACHDEVA
Suffix:
Gender:F
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:PO BOX 1963
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-1963
Mailing Address - Country:US
Mailing Address - Phone:601-981-5887
Mailing Address - Fax:
Practice Address - Street 1:1501 ASTON AVE # 200
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2734
Practice Address - Country:US
Practice Address - Phone:601-249-5526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18057207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00234166OtherRAIL ROAD MEDICARE
MS08534501Medicaid
MS900000037Medicare PIN
MSP00234166OtherRAIL ROAD MEDICARE
MSG39923Medicare UPIN