Provider Demographics
NPI:1124000153
Name:MEYER, KATHRYN J (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:J
Last Name:MEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 402422
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2422
Mailing Address - Country:US
Mailing Address - Phone:302-733-0806
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:219 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2913
Practice Address - Country:US
Practice Address - Phone:410-822-1000
Practice Address - Fax:410-819-0712
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044246207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD049661800Medicaid
MDHZ63Medicare ID - Type Unspecified
MD049661800Medicaid