MEDICARE: MICHAEL PETER MEYER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	7175A	WY

General Provider Information

NPI Number	:	1548263700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PETER MEYER M.D.

Provider Business Mailing Address
First Line	:	1000 EAST UNIVERSITY AVE # 3068
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82071-3068
Country	:	US
Telephone Number	:	307-766-2130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 E UNIVERSITY AVE # 3068
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82071-2000
Country	:	US
Telephone Number	:	307-766-2130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/04/2008

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