Basic Information
| Provider Information | |||||||||
| NPI: | 1487880993 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 FRUIT STREET | ||||||||
| Address2: | MASSACHUSETTS GENERAL HOSPITAL | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177263030 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8 PROSPECT ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179433463 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2009 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | L-240754 | MA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 21896 | NH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.