MEDICARE: MATTHEW W MEIER LLC

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	261QM2500X	Medical Specialty Clinic/Center	R9J58	MO

General Provider Information

NPI Number	:	1801084421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW W MEIER LLC

Provider Business Mailing Address
First Line	:	1002 PERUQUE CROSSING COURT
Second Line	:	SUITE102
City	:	OFALLON
State	:	MO
Zip	:	63366-2362
Country	:	US
Telephone Number	:	636-294-5757
Fax Number	:	636-294-5742

Provider Business Practice Location Address
First Line	:	1002 PERUQUE CROSSING CT
Second Line	:	SUITE 102
City	:	O FALLON
State	:	MO
Zip	:	63366-2362
Country	:	US
Telephone Number	:	636-294-5757
Fax Number	:	636-294-5742

Authorized Official
Title or Position	:	OFICE MANAGER
Name	:	MRS. TAMARA LYNN ROTH
Credential	:
Telephone Number	:	636-294-5757

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	11/29/2012

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Directions to “MATTHEW W MEIER LLC ” Practice Location

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