Provider Demographics
NPI:1881799773
Name:MEINIG, MARTIN L (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:L
Last Name:MEINIG
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 1:2640 BIEHN STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1181
Mailing Address - Country:US
Mailing Address - Phone:541-205-6890
Mailing Address - Fax:
Practice Address - Street 1:2640 BIEHN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1181
Practice Address - Country:US
Practice Address - Phone:541-205-6890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233239207V00000X
ORMD27787207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278887Medicaid
VAH80754Medicare UPIN
OR278887Medicaid