Healthcare Provider Details

I. General information

NPI: 1003974163
Provider Name (Legal Business Name): GERRY MEIER OTR L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W CENTURY AVE
BISMARCK ND
58503-1401
US

IV. Provider business mailing address

300 W CENTURY AVE
BISMARCK ND
58503-1401
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-9900
  • Fax: 701-323-9911
Mailing address:
  • Phone: 701-323-9900
  • Fax: 701-323-9911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number105
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: