Provider Demographics
NPI:1548388929
Name:MEYER, MIKEL R (DO)
Entity Type:Individual
Prefix:
First Name:MIKEL
Middle Name:R
Last Name:MEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3285 TRUMPETER CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3935
Mailing Address - Country:US
Mailing Address - Phone:775-356-8181
Mailing Address - Fax:775-827-6947
Practice Address - Street 1:255 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5775
Practice Address - Country:US
Practice Address - Phone:775-356-8181
Practice Address - Fax:775-332-8085
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVNV18692083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBK083BMedicare PIN
NVBL325YMedicare UPIN
NVBL325ZMedicare UPIN
NVBK083AMedicare PIN