Provider Demographics
NPI:1336313774
Name:MYERS & MILLER PODIATRY INC
Entity Type:Organization
Organization Name:MYERS & MILLER PODIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-339-6233
Mailing Address - Street 1:515 UNION AVE
Mailing Address - Street 2:SUITE 147
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3004
Mailing Address - Country:US
Mailing Address - Phone:330-339-6233
Mailing Address - Fax:330-343-8460
Practice Address - Street 1:515 UNION AVE
Practice Address - Street 2:SUITE 147
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3004
Practice Address - Country:US
Practice Address - Phone:330-339-6233
Practice Address - Fax:330-343-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003164M213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000579655OtherANTHEM
OH2868884Medicaid
OHP00664490OtherRAILROAD MEDICARE
OHP00662344OtherRAILROAD MEDICARE
OH000000579652OtherANTHEM
OHP00653532OtherRAILROAD MEDICARE PART B
OH000000579653OtherANTHEM
OH000000579653OtherANTHEM
OHP00653532OtherRAILROAD MEDICARE PART B