Provider Demographics
NPI:1710949268
Name:MEIER, RUDOLF KURT III (DPM)
Entity Type:Individual
Prefix:DR
First Name:RUDOLF
Middle Name:KURT
Last Name:MEIER
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 ROUTE 88 E
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3265
Mailing Address - Country:US
Mailing Address - Phone:732-899-4493
Mailing Address - Fax:732-899-6801
Practice Address - Street 1:2095 ROUTE 88 E
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3265
Practice Address - Country:US
Practice Address - Phone:732-899-4493
Practice Address - Fax:732-899-6801
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002055213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
223110187OtherHORIZON BC/BS NJ
NJ4515901Medicaid
NJT87592Medicare UPIN
NJME473151Medicare PIN
223110187OtherHORIZON BC/BS NJ