Provider Demographics
NPI:1891785614
Name:MEYER, SUE E (MD)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:E
Last Name:MEYER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3515 MASSILLON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6400
Mailing Address - Country:US
Mailing Address - Phone:330-899-9350
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:65 COMMUNITY RD
Practice Address - Street 2:SUITE C
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2357
Practice Address - Country:US
Practice Address - Phone:330-633-6601
Practice Address - Fax:330-633-4476
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-09-12
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Provider Licenses
StateLicense IDTaxonomies
OH35052075M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH602575Medicaid
OH602575Medicaid
OHME0577905Medicare PIN