1578768024 NPI number — DR. CHRISTOPHER PATRICK MYERS M.D., PH.D.

Table of content: DR. CHRISTOPHER PATRICK MYERS M.D., PH.D. (NPI 1578768024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578768024 NPI number — DR. CHRISTOPHER PATRICK MYERS M.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MYERS
Provider First Name:
CHRISTOPHER
Provider Middle Name:
PATRICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578768024
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 MEDICAL PKWY STE 235
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-266-2770
Provider Business Mailing Address Fax Number:
410-841-6251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 MEDICAL PKWY STE 235
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-266-2770
Provider Business Practice Location Address Fax Number:
410-841-6251
Provider Enumeration Date:
06/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  D66722 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1069 . This is a "ARA - BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 10690036 . This is a "BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 38110091 . This is a "SHIPLEYS IMAGING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CA1932 P01063488 . This is a "AAD RAILROAD PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: KC46SH 60340002 . This is a "SHIPLEYS IMAGING CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 044204600 . This is a "MEDICAL ASSISTANCE - SHIPLEYS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S645 60056008 . This is a "AAD CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 044204600 . This is a "ARA MEDICAID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 044204600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 219037DZYC . This is a "MEDICARE PIN - BCF GROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 219037ZCKL . This is a "SHIPLEYS GROUP PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 219037ZEDL . This is a "AAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: K606AN . This is a "ARA - BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 10730030 . This is a "AAD PROVIDER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 219037ZD7B . This is a "AAD GROUP PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CK4885 P01055819 . This is a "BOWIE RAILROAD PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9052710 . This is a "AETNA AAD SHIPLEYS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com