Individual
THEODORE MARK MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 UNIVERSITY PKWY, SUITE 2400, AIKEN, SC 29801
(803) 642-5050
(803) 642-3369
Mailing address
PO BOX 2845, AIKEN, SC 29802-2845
(803) 642-5050
(803) 642-3369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7852
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110048687
RAILROAD MEDICARE
SC
05
—
O78524
—
SC
Enumeration date
11/15/2006
Last updated
03/17/2018
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