Provider Demographics
NPI:1346423530
Name:BARRY S. MEYER,D.O., P.C.
Entity Type:Organization
Organization Name:BARRY S. MEYER,D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-755-5400
Mailing Address - Street 1:23423 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-1927
Mailing Address - Country:US
Mailing Address - Phone:586-755-5400
Mailing Address - Fax:586-755-0066
Practice Address - Street 1:23423 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-1927
Practice Address - Country:US
Practice Address - Phone:586-755-5400
Practice Address - Fax:586-755-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty