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

Table of content: MELISSA ANN HAVERKAMP APRN, FNP-C (NPI 1962144402)

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".




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