Healthcare Provider Details

I. General information

NPI: 1720052517
Provider Name (Legal Business Name): STEPHEN E MEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 STATE ROUTE 60 STE 6
VERMILION OH
44089
US

IV. Provider business mailing address

PO BOX 636643
CINCINNATI OH
45263-6643
US

V. Phone/Fax

Practice location:
  • Phone: 440-967-8713
  • Fax: 440-967-1938
Mailing address:
  • Phone: 440-989-3801
  • Fax: 440-960-0264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35041969
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: