Provider Demographics
NPI:1740411990
Name:MEYER, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:MEYER
Suffix:
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 1:307 W HWY 54
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7846
Mailing Address - Country:US
Mailing Address - Phone:162-180-0083
Mailing Address - Fax:316-218-0003
Practice Address - Street 1:307 W HWY 54
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7846
Practice Address - Country:US
Practice Address - Phone:316-218-0008
Practice Address - Fax:316-218-0003
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200623260AMedicaid
KSP00771517Medicare PIN
KS111078007Medicare PIN
KS004052009Medicare PIN