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General NPI Number Information
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NPI Number | 1154308724
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Entity Type | Individual
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Provider Name | MICHAEL G MEYERS DPM
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 680 3 MILE RD NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49544-8218
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Country | US
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Telephone | 616-785-8707
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 LEONARD ST NW SUITE 103
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City | WALKER
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State | MI
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Zip | 49534-8447
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Country | US
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Telephone | 616-453-6329
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Fax | 616-453-1725
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MM001160
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License Number State | MI
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