Provider Demographics
NPI:1730113762
Name:MEYER & BOPP DPM
Entity Type:Organization
Organization Name:MEYER & BOPP DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-477-0441
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7854
Mailing Address - Country:US
Mailing Address - Phone:732-477-0441
Mailing Address - Fax:732-477-9057
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:SUITE 1A
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7854
Practice Address - Country:US
Practice Address - Phone:732-477-0441
Practice Address - Fax:732-477-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ480013917OtherRAILROAD MEDICARE
NJ5391806Medicaid
U12211Medicare UPIN
NJ121100Medicare PIN
NJ480013917OtherRAILROAD MEDICARE