Provider Demographics
NPI:1376576249
Name:MEYER, JEFFREY DAVID (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:9055 SPRINGBROOK DR NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5841
Practice Address - Country:US
Practice Address - Phone:763-780-9155
Practice Address - Fax:763-236-1066
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN297752083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4084325OtherAETNA INS
MN886883200Medicaid
MN65D13MEOtherBCBS OF MN
MN23230OtherAMERICA'S PPO
MNHP18550OtherHEALTHPARTNERS
MN0417498OtherMEDICA #
MN1000840OtherPREFERRED ONE
MN109882OtherUCARE MN #
MNH400142767Medicare PIN
MNA95800Medicare UPIN
MNHP18550OtherHEALTHPARTNERS