MEDICARE: BARRY S. MEYER,D.O., P.C.

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	207R00000X	Internal Medicine Physician	5101011427	MI

General Provider Information

NPI Number	:	1346423530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY S. MEYER,D.O., P.C.

Provider Business Mailing Address
First Line	:	23423 RYAN RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-1927
Country	:	US
Telephone Number	:	586-755-5400
Fax Number	:	586-755-0066

Provider Business Practice Location Address
First Line	:	23423 RYAN RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-1927
Country	:	US
Telephone Number	:	586-755-5400
Fax Number	:	586-755-0066

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BARRY MEYER
Credential	:	D.O.
Telephone Number	:	586-755-5400

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	12/11/2007

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