Provider Demographics
NPI:1588661771
Name:MEYERS, PETER J (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:MEYERS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:49650 CHERRY HILL RD
Practice Address - Street 2:SUITE 130
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4849
Practice Address - Country:US
Practice Address - Phone:734-398-7800
Practice Address - Fax:734-398-7805
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2016-11-18
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Provider Licenses
StateLicense IDTaxonomies
MI5101015038207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI114633030Medicaid
I17083Medicare UPIN
0M74020012Medicare ID - Type Unspecified