Provider Demographics
NPI:1811056849
Name:MEYER, ROBERT W (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 PARRISH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1791
Mailing Address - Country:US
Mailing Address - Phone:585-394-1960
Mailing Address - Fax:585-393-9232
Practice Address - Street 1:229 PARRISH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1791
Practice Address - Country:US
Practice Address - Phone:585-394-1960
Practice Address - Fax:585-393-9232
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206546207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
109980OtherMVP
P010206546OtherEXCELLUS
NY01752230Medicaid
NY01752230Medicaid