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Individual

DR. CHARLES E MYERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
303 S MAIN ST, SUITE 108, MISHAWAKA, IN 46544-2159
(574) 255-3108
(574) 255-3100
Mailing address
303 S MAIN ST, SUITE 108, MISHAWAKA, IN 46544-2159
(574) 255-3108
(574) 255-3100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025417
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100222130
IN
Enumeration date
09/26/2005
Last updated
07/16/2008
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