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NPI Code Detail

MEDICARE: NICHOLAS ALBERT MEYER MD

MEDICARE: NICHOLAS ALBERT MEYER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician32343WI
2207RC0200XCritical Care Medicine (Internal Medicine) Physician2006001559MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245294131
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ALBERT MEYER MD
Provider Business Mailing Address
First Line : 4425 N PORT WASHINGTON RD
Second Line :
City : GLENDALE
State : WI
Zip : 53212-1082
Country : US
Telephone Number : 414-319-3000
Fax Number :
Provider Business Practice Location Address
First Line : 2311 N PROSPECT AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-4445
Country : US
Telephone Number : 414-319-3000
Fax Number : 414-319-3033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 03/08/2016

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