Provider Demographics
NPI:1316099062
Name:FOUSHEE, MEREDITH NEAL (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:NEAL
Last Name:FOUSHEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 EDGEWATER DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3514
Mailing Address - Country:US
Mailing Address - Phone:843-259-0888
Mailing Address - Fax:
Practice Address - Street 1:6334 ROSWELL RD
Practice Address - Street 2:SUITE C
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3210
Practice Address - Country:US
Practice Address - Phone:678-812-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5880363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical