Provider Demographics
NPI:1780780734
Name:MEERMANS, WILLIAM ROBERT JR (PHD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:MEERMANS
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4201
Mailing Address - Country:US
Mailing Address - Phone:517-351-1234
Mailing Address - Fax:517-333-8777
Practice Address - Street 1:415 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4201
Practice Address - Country:US
Practice Address - Phone:517-351-1234
Practice Address - Fax:517-333-8777
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801007002103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P30430002Medicare ID - Type Unspecified