Provider Demographics
NPI:1154755239
Name:ST AMAND, COLTON MEIER (PHD, MD)
Entity type:Individual
Prefix:DR
First Name:COLTON
Middle Name:MEIER
Last Name:ST AMAND
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:DR
Other - First Name:COLTON
Other - Middle Name:LAWRENCE
Other - Last Name:KEO-MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3456
Mailing Address - Fax:
Practice Address - Street 1:1 FOXCARE DR STE 103
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2060
Practice Address - Country:US
Practice Address - Phone:607-431-5757
Practice Address - Fax:607-431-5038
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN69857207Q00000X
NY324133207Q00000X
TX36071103TC0700X
MN31290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical