Healthcare Provider Details

I. General information

NPI: 1548576002
Provider Name (Legal Business Name): ERICA MEYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 UNIT 2 HOWARD AVENUE
WINDSOR ONTARIO
N8X 3V2
CA

IV. Provider business mailing address

2285 UNIT 2 HOWARD AVENUE
WINDSOR ONTARIO
N8X 3V2
CA

V. Phone/Fax

Practice location:
  • Phone: 519-254-7979
  • Fax:
Mailing address:
  • Phone: 519-254-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301104340
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: