Basic Information
| Provider Information | |||||||||
| NPI: | 1366478505 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MELTZER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 THIRD STREET SE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200030001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024457044 | ||||||||
| FaxNumber: | 2027412921 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 PENNSYLVANIA AVENUE NW | ||||||||
| Address2: | SUITE 2B | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200373307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027412904 | ||||||||
| FaxNumber: | 2027412921 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 08/28/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | D0062842 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 381221900 | 05 | MD | MEDICAID |