Provider Demographics
NPI:1356473839
Name:MEYER, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 615
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-0615
Mailing Address - Country:US
Mailing Address - Phone:978-266-2676
Mailing Address - Fax:978-266-2680
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-946-8103
Practice Address - Fax:978-946-8067
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2318242085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA496300OtherTUFTS HEALTH PLAN
AA92725OtherHARVARD PILGRIM
NH01Y011955MA01OtherNH BS ANTHEM
126204OtherFALLON
MAJ41852OtherBLUE SHIELD
P00418734OtherRR MEDICARE
MA2137062Medicaid
NH30206943Medicaid
MA7109926OtherAETNA/USHC
NH30206943Medicaid