Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 105 | ND |
NPI | 1003974163 |
---|---|
Provider Name | Mr. Gerry Meier |
First Address | Bismarck, ND 58503-1401 |
Second Address | Bismarck, ND 58503-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |