Provider Demographics
NPI:1922031889
Name:MEYER, RONALD CARROLL (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CARROLL
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3555 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6027
Mailing Address - Country:US
Mailing Address - Phone:720-284-3700
Mailing Address - Fax:303-467-0525
Practice Address - Street 1:3555 LUTHERAN PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6027
Practice Address - Country:US
Practice Address - Phone:720-284-3700
Practice Address - Fax:303-467-0525
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16379208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01163799Medicaid
COD23054Medicare UPIN