Provider Demographics
NPI:1134320526
Name:MYERS, JUSTIN GUY (DO)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:GUY
Last Name:MYERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-6407
Mailing Address - Country:US
Mailing Address - Phone:804-564-4533
Mailing Address - Fax:
Practice Address - Street 1:8260 ATLEE ROAD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-569-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202183207P00000X
VA0116017420390200000X
NC188876207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program