Healthcare Provider Details

I. General information

NPI: 1598737207
Provider Name (Legal Business Name): GRAHAM SCOTT MEYER MD FACEP FAAEM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 ADAIR DR
GOLDSBORO NC
27530-4516
US

IV. Provider business mailing address

2415 RAEFORD RD
FAYETTEVILLE NC
28305-5115
US

V. Phone/Fax

Practice location:
  • Phone: 919-648-4435
  • Fax: 910-267-8932
Mailing address:
  • Phone: 910-584-6909
  • Fax: 910-484-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9500405
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number9500405
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: