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Individual

MICHAEL T MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8600 N KENTUCKY AVE, EVANSVILLE, IN 47725-6302
(812) 426-9565
(812) 426-9572
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 426-9565
(812) 426-9572

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01056009A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000218438
ANTHEM
IN
05
200371090
IN
01
64046683
KY MEDICAID
KY
Enumeration date
11/30/2006
Last updated
07/12/2013
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