Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DS026536L | PA |
NPI | 1386919447 |
---|---|
Provider Name | Dr. Karl Albert Meyer |
First Address | Sunbury, PA 17801-3411 |
Second Address | Sunbury, PA 17801-3411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2012 |
Last Update Date | 21/03/2012 |