Provider Demographics
NPI:1528017209
Name:MEIER, MARK CONDON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CONDON
Last Name:MEIER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-377-0777
Mailing Address - Fax:208-377-1070
Practice Address - Street 1:6165 W EMERALD STREET
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8613
Practice Address - Country:US
Practice Address - Phone:208-377-0777
Practice Address - Fax:208-377-1070
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-04-07
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Provider Licenses
StateLicense IDTaxonomies
IDM6050207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010005987OtherREGENCE BLUE SHIELD
IDP00199273OtherTRAVELERS MEDICARE
ID10504OtherBLUE CROSS