Basic Information
| Provider Information | |||||||||
| NPI: | 1841238094 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5450 FRANTZ RD STE 360 | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430164141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145446155 | ||||||||
| FaxNumber: | 6145446370 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 HOSPITAL DR STE 350 | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457012867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405924491 | ||||||||
| FaxNumber: | 7405924844 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 34-00-6116 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RA0401X | 34.006116 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000185267 | 01 | OH | UNISON MEDICAID | OTHER | 3002197000 | 05 | WV | MEDICAID | 000000212032 | 01 | ANTHEM BCBS | OTHER | 100015089 | 01 | RR MEDICARE | OTHER | 0131191 | 01 | OH | MOLINA MEDICAID | OTHER | 0131191 | 05 | OH | MEDICAID | 310917085074 | 01 | OH | CARESOURCE MEDICAID | OTHER |