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Individual

MICHAEL C. MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5289
(740) 446-5697
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5289
(740) 446-5697

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
1416
WV
2085R0202X
Diagnostic Radiology Physician
Primary
34-00-5682
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000007369
ANTHEM BCBS
01
000000191101
UNISON MEDICAID
OH
01
001714061
MOUNTAIN STATE BCBS
05
0119559000
WV
01
0929179
MOLINA MEDICAID
OH
01
300032014
RR MEDICARE
Enumeration date
06/07/2006
Last updated
11/06/2020
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