Basic Information
| Provider Information | |||||||||
| NPI: | 1942658919 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRYDEN | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STEIN | ||||||||
| OtherFirstName: | MEREDITH | ||||||||
| OtherMiddleName: | K | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1215 DUFF AVENUE | ||||||||
| Address2: | |||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7127921500 | ||||||||
| FaxNumber: | 7127927597 | ||||||||
| Practice Location | |||||||||
| Address1: | 1214 SOUTH GRANT ROAD | ||||||||
| Address2: | |||||||||
| City: | CARROLL | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7127921500 | ||||||||
| FaxNumber: | 7127927597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2016 | ||||||||
| LastUpdateDate: | 01/11/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 7659 | NE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 45626 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.