Provider Demographics
NPI:1871792408
Name:R. D. MEYER, M.D.
Entity type:Organization
Organization Name:R. D. MEYER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-335-1500
Mailing Address - Street 1:1200 S EUCLID AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-0433
Mailing Address - Country:US
Mailing Address - Phone:605-335-1500
Mailing Address - Fax:605-335-3067
Practice Address - Street 1:1200 S EUCLID AVE STE 210
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0433
Practice Address - Country:US
Practice Address - Phone:605-335-1500
Practice Address - Fax:605-335-3067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2782207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6000120Medicaid
SDE25397Medicare UPIN