Provider Demographics
NPI:1669488623
Name:MEIER, LEO BRIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:BRIAN
Last Name:MEIER
Suffix:
Gender:M
Credentials:PA-C
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 645409
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-5252
Mailing Address - Country:US
Mailing Address - Phone:330-386-6442
Mailing Address - Fax:330-386-3660
Practice Address - Street 1:123 W 6TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2921
Practice Address - Country:US
Practice Address - Phone:330-385-7170
Practice Address - Fax:330-385-6359
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050843363A00000X
OH50001626363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P50202Medicare UPIN
054968Medicare ID - Type Unspecified