Healthcare Provider Details

I. General information

NPI: 1982664264
Provider Name (Legal Business Name): MARK STEPHEN MEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 10/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 CHANCELLOR DR
CRESTVIEW HILLS KY
41017-5427
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-0288
  • Fax: 859-341-7482
Mailing address:
  • Phone: 859-341-0288
  • Fax: 859-341-7482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number24163
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24163
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: