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Individual

MR. DAVID W. MYERS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
BLDG 5-4257 BASTOGNE STREET EXTENSION, FORT BRAGG, NC 28310-0001
(910) 907-2575
(910) 396-5754
Mailing address
4483 KINKEAD CT, FAYETTEVILLE, NC 28314-2487
(910) 864-1284

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102708
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102708
STATE MED BOARD LICENSE
NC
Enumeration date
03/29/2006
Last updated
07/08/2007
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