Provider Demographics
NPI:1003905670
Name:MYERS, CHRISTOPHER ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15511
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28408-5511
Mailing Address - Country:US
Mailing Address - Phone:910-262-7107
Mailing Address - Fax:910-798-2303
Practice Address - Street 1:3208 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-0800
Practice Address - Country:US
Practice Address - Phone:910-794-3929
Practice Address - Fax:910-798-2303
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC286202084F0202X, 2084P0800X
NC2004015472084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2347934Medicare UPIN