Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 18534 | MA |
NPI | 1033205141 |
---|---|
Provider Name | Dr. Christian Josef Meyer |
First Address | Woburn, MA 01801-5984 |
Second Address | Woburn, MA 01801-5984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 22/08/2014 |