Individual
BRUCE P MEYER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
453 WATERBURY CT, SUITE 220, GAHANNA, OH 43230-5309
(614) 471-0652
(614) 509-6001
Mailing address
453 WATERBURY CT, SUITE 220, GAHANNA, OH 43230-5309
(614) 471-0652
(614) 509-6001
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35-02-7482-M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150947
—
OH
Enumeration date
03/24/2006
Last updated
07/08/2007
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