| Organization Name: | MERIDIAN MEDICAL ASSOCIATES, LLC |
| NPI Number: | 1104289297 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARRYL ANTOINE HOOKER (CO-OWNER) |
| Mailing Address: | 5620 Saint Barnabas Rd Suite 340 Oxon Hill |
| State: | MD US |
| Postal Code: | 207453628 |
| Phone Number: | 2407664408 |
| Fax Number: | 2407664409 |
| NPI Enumeration Date: | 04/05/2016 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | C0005314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |