Provider Demographics
NPI:1871798892
Name:MEANS, NORMAN D (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:D
Last Name:MEANS
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 1:506 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45882-9228
Mailing Address - Country:US
Mailing Address - Phone:419-363-3008
Mailing Address - Fax:419-363-2093
Practice Address - Street 1:125 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2002
Practice Address - Country:US
Practice Address - Phone:260-919-3470
Practice Address - Fax:260-479-2980
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35130872207Q00000X, 207ZP0102X
AK5269207Q00000X, 207ZP0102X
IN01081722A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0233488Medicaid
F88616Medicare UPIN