Healthcare Provider Details

I. General information

NPI: 1285832659
Provider Name (Legal Business Name): ANDREW JOSEPH MEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ RM 4648
AKRON OH
44308-1063
US

IV. Provider business mailing address

1 PERKINS SQ RM 4648
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8823
  • Fax: 330-543-3593
Mailing address:
  • Phone: 330-543-8823
  • Fax: 330-543-3593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.099175
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number35.099175
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number43010090303
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: