Individual
BRUCE MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5101 MINNEHAHA AVE, MINNEAPOLIS, MN 55417-1647
(612) 317-3102
Mailing address
10340 NESBITT AVE S, BLOOMINGTON, MN 55437-2215
(952) 835-4056
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
6637A
WY
207R00000X
Internal Medicine Physician
Primary
6637A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117200000
—
WY
Enumeration date
06/20/2005
Last updated
05/11/2015
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