MEDICARE: HERB MEYER FAMILY PRACTICE

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
1	207Q00000X	Family Medicine Physician
2	207QA0401X	Addiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1265037584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERB MEYER FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	391 MAIN ST
Second Line	:
City	:	DANVILLE
State	:	NH
Zip	:	03819-3219
Country	:	US
Telephone Number	:	603-303-0646
Fax Number	:

Provider Business Practice Location Address
First Line	:	391 MAIN ST
Second Line	:
City	:	DANVILLE
State	:	NH
Zip	:	03819-3219
Country	:	US
Telephone Number	:	603-303-0646
Fax Number	:	603-382-8595

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HERB T MEYER
Credential	:	DO
Telephone Number	:	603-303-0646

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/09/2020

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