Provider Demographics
NPI:1134176571
Name:MEYER, CHRISTOPHER GLENN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GLENN
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:PO BOX 12571
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4016
Mailing Address - Country:US
Mailing Address - Phone:321-252-0327
Mailing Address - Fax:863-215-7085
Practice Address - Street 1:201 N LAKEMONT AVE
Practice Address - Street 2:STE 700
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3228
Practice Address - Country:US
Practice Address - Phone:321-252-0327
Practice Address - Fax:863-215-7085
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME905592086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270219300Medicaid
FL47550OtherBCBS
FL7005528OtherAETNA
FLU3739ZMedicare ID - Type Unspecified
FL47550OtherBCBS