Provider Demographics
NPI:1164469318
Name:MEYER, MICHAEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:14900 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-9651
Mailing Address - Country:US
Mailing Address - Phone:269-781-6600
Mailing Address - Fax:269-781-9228
Practice Address - Street 1:14900 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-9651
Practice Address - Country:US
Practice Address - Phone:269-781-6600
Practice Address - Fax:269-781-9228
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101009453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC33992Medicare UPIN