Provider Demographics
NPI:1316199458
Name:MEYERS, RAYMOND F
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:F
Last Name:MEYERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS NEW HAMPSHIRE (SSN 778)
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09579-2302
Mailing Address - Country:US
Mailing Address - Phone:860-694-7782
Mailing Address - Fax:
Practice Address - Street 1:USS NEW HAMPSHIRE
Practice Address - Street 2:SSN 778
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09579-2302
Practice Address - Country:US
Practice Address - Phone:860-694-7782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1710I1002X1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman