Provider Demographics
NPI:1336408244
Name:MEUSER-HERR, NATHANIEL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:DAVID
Last Name:MEUSER-HERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NATHANIEL
Other - Middle Name:DAVID
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:251 SALINA MEADOWS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4516
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:90 PRESIDENTIAL PLAZA
Practice Address - Street 2:3RD FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-464-4357
Practice Address - Fax:315-464-2030
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59196208000000X
NY298090208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics