Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 07001322A | IN |
NPI | 1063868396 |
---|---|
Provider Name | Andrew Meyer |
First Address | Lafayette, IN 47904-2694 |
Second Address | Lafayette, IN 47904-2694 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2016 |
Last Update Date | 21/05/2020 |