Provider Demographics
NPI:1144236290
Name:MEYER, PAUL ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ALEXANDER
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5849
Mailing Address - Country:US
Mailing Address - Phone:989-401-8916
Mailing Address - Fax:989-372-9867
Practice Address - Street 1:355 N CENTER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5849
Practice Address - Country:US
Practice Address - Phone:989-401-8916
Practice Address - Fax:989-372-9867
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E66019OtherMEDICARE GROUP MIDLAND REDIMED
MI01-0-Z9-6017-0OtherBCBSM BAY CITY REDIMED GROUP
MI3170078Medicaid
MI01-0-Z9-1103-0OtherBCBSM ESSEXVILLE GROUP
MI0Z96017OtherMEDICARE BAY CITY REDIMED GROUP
MI01-0-E6-6019-0OtherBCBSM MIDLAND GROUP
MI0P43930OtherMEDICARE ESSEXVILLE GROUP
MI3170078Medicaid
MI01-0-E6-6019-0OtherBCBSM MIDLAND GROUP