Provider Demographics
NPI:1013185008
Name:BRUCE C MEYERS
Entity Type:Organization
Organization Name:BRUCE C MEYERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-652-8050
Mailing Address - Street 1:969 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1318
Mailing Address - Country:US
Mailing Address - Phone:248-652-8050
Mailing Address - Fax:248-652-8051
Practice Address - Street 1:969 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1318
Practice Address - Country:US
Practice Address - Phone:248-652-8050
Practice Address - Fax:248-652-8051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBM000915213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0993010001Medicare NSC