Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 2007016516 | MO |
NPI | 1003868951 |
---|---|
Provider Name | Thomas Wesley Meyer |
First Address | Columbia, MO 65212-0001 |
Second Address | Columbia, MO 65201-5844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 10/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204923809 | (05) | MO |