Provider Demographics
NPI:1972708501
Name:ARTHUR, MEREDITH M (DO)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:M
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MEREDITH
Other - Middle Name:M
Other - Last Name:LEQUEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:21 HIGHLAND AVE SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24013
Mailing Address - Country:US
Mailing Address - Phone:540-344-9213
Mailing Address - Fax:540-345-7559
Practice Address - Street 1:21 HIGHLAND AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2218
Practice Address - Country:US
Practice Address - Phone:540-344-9213
Practice Address - Fax:540-345-7559
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20008471208D00000X, 208000000X
VA0102203614208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4132475Medicaid
PA102041014Medicaid
NJ140813Medicaid
VA1972708501Medicaid