Provider Demographics
NPI:1629067996
Name:MEYER, WALTER E III (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:E
Last Name:MEYER
Suffix:III
Gender:M
Credentials:MD
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 2324
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35201-2324
Mailing Address - Country:US
Mailing Address - Phone:256-533-6488
Mailing Address - Fax:256-533-6495
Practice Address - Street 1:119 LONGWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-533-6488
Practice Address - Fax:256-533-6495
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008811207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000089181Medicaid
AL000089181Medicaid
AL000089181Medicare ID - Type Unspecified