Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 12009256A | IN |
NPI | 1043219199 |
---|---|
Provider Name | Dr. Allen Wesley Meier |
First Address | Bloomington, IN 47401-8557 |
Second Address | Bloomington, IN 47401-8557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 08/07/2007 |