Individual
SCOTT LEE MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2135
(757) 483-8730
Mailing address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2135
(757) 483-8730
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1387774641
TRICARE
—
Enumeration date
09/28/2021
Last updated
09/28/2021
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