Basic Information
Provider Information
NPI: 1285612002
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEIER
FirstName: MICHAEL
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3421 W 9TH ST
Address2:  
City: WATERLOO
State: IA
PostalCode: 507025401
CountryCode: US
TelephoneNumber: 3192725000
FaxNumber: 3192725264
Practice Location
Address1: 3421 W 9TH ST
Address2:  
City: WATERLOO
State: IA
PostalCode: 507025401
CountryCode: US
TelephoneNumber: 3192725000
FaxNumber: 3192725264
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 12/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X04-26919KSN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XMD-48046IAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
100287630A05KS MEDICAID


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