Healthcare Provider Details

I. General information

NPI: 1114067543
Provider Name (Legal Business Name): GERALD M MEYER JR. HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6530 SECOR RD STE 9
LAMBERTVILLE MI
48144-9456
US

IV. Provider business mailing address

6530 SECOR RD STE 9
LAMBERTVILLE MI
48144-9456
US

V. Phone/Fax

Practice location:
  • Phone: 419-262-6299
  • Fax:
Mailing address:
  • Phone: 419-262-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501004363
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: