Provider Demographics
NPI:1225168974
Name:NIEMEYER, MEINDERT ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MEINDERT
Middle Name:ALBERT
Last Name:NIEMEYER
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:PO BOX 1248
Mailing Address - Street 2:812 WEST HAGGARD AVE
Mailing Address - City:ELON
Mailing Address - State:NC
Mailing Address - Zip Code:27244
Mailing Address - Country:US
Mailing Address - Phone:336-449-4030
Mailing Address - Fax:336-449-5315
Practice Address - Street 1:812 WEST HAGGARD AVE
Practice Address - Street 2:
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244
Practice Address - Country:US
Practice Address - Phone:336-449-4030
Practice Address - Fax:336-449-5315
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC203825AMedicare ID - Type Unspecified
C82095Medicare UPIN