Organization
IAN MYERS, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA CORNELL (CRED COORDINATOR)
(410) 398-4679
Entity
Organization
Contact information
Practice address
106 BOW ST, ELKTON, MD 21921-5544
(410) 398-4000
Mailing address
PO BOX 190, ELKTON, MD 21922-0190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0059266
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00070381
MEDICARE RAILROAD
—
Enumeration date
10/05/2007
Last updated
11/19/2007
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