Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME90559 | FL |
N | 208G00000X | Cardiothoracic Vascular Surgeon | ME90559 | FL |
NPI | 1134176571 |
---|---|
Provider Name | Dr. Christopher Glenn Meyer |
First Address | Belfast, ME 04915-4016 |
Second Address | Winter Park, FL 32792-3228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 23/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270219300 | (05) | FL |
47550 | BCBS (01) | FL |
7005528 | AETNA (01) | FL |
I18054 | (02) |