Provider Demographics
NPI:1356312037
Name:MYERS, COLLIN LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:LEWIS
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 1:7057 AUGUSTA NATIONAL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17222-9419
Mailing Address - Country:US
Mailing Address - Phone:717-215-7912
Mailing Address - Fax:
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2332
Practice Address - Country:US
Practice Address - Phone:717-217-6800
Practice Address - Fax:717-217-6900
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045853L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA227275OtherJOHNS HOPKINS
PA102234941Medicaid
PA804550OtherHIGHMARK BLUE SHIELD
PA001549470Medicaid
MD945951OtherCAREFIRST MD BCBS
PA5531100OtherAETNA NON HMO
PA50083030OtherCAPITAL BLUE CROSS-WMG
PA259370OtherUNISON-WMG
PA8998452OtherAETNA HMO
PA50083030OtherCAPITAL BLUE CROSS-WMG
PAF43803Medicare UPIN
PA804550Medicare PIN