Provider Demographics
NPI:1487344743
Name:BARA, MEREDITH JEAN (MD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JEAN
Last Name:BARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FRUIT STREET, WHITE 270
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MD
Mailing Address - Zip Code:01224
Mailing Address - Country:US
Mailing Address - Phone:617-643-2009
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET, WHITE 270
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MD
Practice Address - Zip Code:01224
Practice Address - Country:US
Practice Address - Phone:617-643-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program