Provider Demographics
NPI:1497251805
Name:MEYER, SETH A
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:A
Last Name:MEYER
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:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:OSGOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45351-0021
Mailing Address - Country:US
Mailing Address - Phone:419-852-5427
Mailing Address - Fax:
Practice Address - Street 1:1201 EXPERIMENT FARM RD STE F
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2064
Practice Address - Country:US
Practice Address - Phone:937-332-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.09625208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation