Provider Demographics
NPI:1649275801
Name:MEYER, DAVID R (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:MEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:811 REDGATE AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1515
Mailing Address - Country:US
Mailing Address - Phone:757-668-7007
Mailing Address - Fax:757-668-8658
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7007
Practice Address - Fax:757-668-8658
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022011322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00287422OtherRR MEDICARE
VA00W968W08Medicare PIN
VAH27773Medicare UPIN