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General NPI Number Information
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NPI Number | 1578574372
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Entity Type | Individual
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Provider Name | MR. MATTHEW MEIER
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 1002 PERUQUE CROSSING CT SUITE 102
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City | O FALLON
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State | MO
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Zip | 63366-2362
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Country | US
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Telephone | 636-294-5757
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Fax | 636-294-5742
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Provider Business Mailing Address
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Address Line | 51 CATAMARAN DR
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-2904
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Country | US
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Telephone | 636-561-2418
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DOR9J58
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License Number State | MO
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