Provider Demographics
NPI:1275514630
Name:MEYER, HOWARD R (DC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:R
Last Name:MEYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 PENDLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-5160
Mailing Address - Country:US
Mailing Address - Phone:317-546-5164
Mailing Address - Fax:317-542-7226
Practice Address - Street 1:7102 PENDLETON PIKE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5160
Practice Address - Country:US
Practice Address - Phone:317-546-5164
Practice Address - Fax:317-542-7226
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000899A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100278000AMedicaid
IN959760Medicare ID - Type Unspecified
IN100278000AMedicaid