MEDICARE: DARREN LEE MEYER OD

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	152W00000X	Optometrist	4901004365	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1821099367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN LEE MEYER OD

Provider Business Mailing Address
First Line	:	26289 W CHICAGO RD
Second Line	:	PO BOX 128
City	:	STURGIS
State	:	MI
Zip	:	49091-8706
Country	:	US
Telephone Number	:	269-651-7874
Fax Number	:	269-651-4154

Provider Business Practice Location Address
First Line	:	26289 W CHICAGO RD
Second Line	:
City	:	STURGIS
State	:	MI
Zip	:	49091-8706
Country	:	US
Telephone Number	:	269-651-7874
Fax Number	:	269-651-4154

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	06/21/2013

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