MEDICARE: ABBY CHRISTINE 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
1	207YP0228X	Pediatric Otolaryngology Physician	54195	MN
2	207Y00000X	Otolaryngology Physician	54195	MN

General Provider Information

NPI Number	:	1477696995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY CHRISTINE MEYER MD

Provider Business Mailing Address
First Line	:	2525 CHICAGO AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-1292
Country	:	US
Telephone Number	:	612-874-1292
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 CHICAGO AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404
Country	:	US
Telephone Number	:	612-874-1292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	05/25/2018

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