Provider Demographics
NPI:1114045382
Name:MYERS, MICHAEL TERRENCE JR (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TERRENCE
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:MD, MBA
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Mailing Address - Street 1:35 CHANNEL CTR ST
Mailing Address - Street 2:UNIT #402
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-3413
Mailing Address - Country:US
Mailing Address - Phone:781-433-3014
Mailing Address - Fax:781-449-3776
Practice Address - Street 1:115 FOURTH AVENUE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2725
Practice Address - Country:US
Practice Address - Phone:781-433-3014
Practice Address - Fax:781-449-3776
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA57242207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine