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Individual

DR. MICHAEL E MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-4000
(260) 482-4442
Mailing address
3640 NEW VISION DR, SUITE A, FORT WAYNE, IN 46845-1717
(260) 482-4440
(260) 482-4442

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01038541A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000012619
MPLAN
01
000000082534
ANTHEM
IN
05
104883177
MI
05
200033410
IN
05
2516254
OH
Enumeration date
09/14/2005
Last updated
05/29/2013
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