Meadow, Philip Bruce
Meadow, Philip Bruce is an sole proprietor health care provider with primary practice located at 700 W Ironwood Dr Ste 275W , Coeur D Alene ID 83814-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Meadow, Philip Bruce can be contacted via phone (208) 625-4780.Contact Information
Primary practice address
700 W Ironwood Dr Ste 275W
Coeur D Alene ID 83814-4400
Phone: (208) 625-4780
Fax: (208) 625-4781
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 043709 | Georgia |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | O-1470 | Idaho |
Profile Details
| NPI number | 1902911878 |
|---|---|
| LBN Legal business name | Meadow, Philip Bruce |
| Credentials | D.O. F.A.C.R. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Feb 15th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902911878 | NPPES |
| Georgia | Other | 660003950 | RAILROAD MEDICARE |
| Georgia | Other | 66BBGB | RAILROAD MEDICARE |
| Georgia | Other | 1437288255 | RAILROAD MEDICARE |
| Georgia | MEDICAID | 000750373C | RAILROAD MEDICARE |
| Georgia | Other | GRP4761 | RAILROAD MEDICARE |
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