Provider Demographics
NPI:1366467797
Name:MEYERS, JEFFERY SAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:SAUL
Last Name:MEYERS
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 1:1600 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4722
Mailing Address - Country:US
Mailing Address - Phone:302-428-5954
Mailing Address - Fax:302-428-5914
Practice Address - Street 1:1600 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4722
Practice Address - Country:US
Practice Address - Phone:302-428-5954
Practice Address - Fax:302-428-5914
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00056872081P2900X
PAMD054290L2081P2900X
NJMA066712002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG30984Medicare UPIN
DE00B367J99Medicare ID - Type UnspecifiedMEDICARE