Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101013421 | MI |
NPI | 1306863014 |
---|---|
Provider Name | Dr. Todd Andrew Meyer |
First Address | Neenah, WI 54956-4993 |
Second Address | Appleton, WI 54915-1846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 21/12/2018 |