Provider Demographics
NPI:1376768929
Name:MEIER, MARK STEPHEN
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:STEPHEN
Last Name:MEIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2876 HENRY ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-7365
Mailing Address - Country:US
Mailing Address - Phone:810-824-0462
Mailing Address - Fax:
Practice Address - Street 1:230 HURON AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3822
Practice Address - Country:US
Practice Address - Phone:810-985-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist