Provider Demographics
NPI:1275866279
Name:MYERS, CHARLES E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:EARLYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22936-0195
Mailing Address - Country:US
Mailing Address - Phone:434-964-0212
Mailing Address - Fax:434-964-0216
Practice Address - Street 1:690 BENT OAKS DR
Practice Address - Street 2:
Practice Address - City:EARLYSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22936-2605
Practice Address - Country:US
Practice Address - Phone:434-964-0212
Practice Address - Fax:434-964-0216
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050527174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist