Provider Demographics
NPI:1215944764
Name:MEYER, JOHN EDWARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:MEYER
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4351 KETTLE MORAINE DR
Mailing Address - Street 2:# 2A
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-3148
Mailing Address - Country:US
Mailing Address - Phone:269-383-2354
Mailing Address - Fax:
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1014
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-966-5592
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002299363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical