Provider Demographics
NPI:1902917610
Name:MEYER, MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S STATE ST
Mailing Address - Street 2:POB 3RD FLOOR
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-257-5777
Practice Address - Street 1:800 N DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1019
Practice Address - Country:US
Practice Address - Phone:302-424-6511
Practice Address - Fax:302-424-6513
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S005881L207V00000X
DEC2-0010757207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1509305OtherGATEWAY
PA160056281OtherRRMCR
PW4392824OtherAETNA
PA4392824OtherUSH/HMO
PA15317700009Medicaid
PA784429OtherBLUE SHIELD
PA172499OtherTHREE RIVERS
PA50051207OtherCAPITAL BLUE CROSS
PA4392824OtherUSH/HMO
PA4392824OtherUSH/HMO