Provider Demographics
NPI:1376655266
Name:MYERS, STEPHEN A (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
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 1:2500 METROHEALTH DRIVE
Mailing Address - Street 2:METROHEALTH SYSTEM / DEPT OF OB/GYN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1998
Mailing Address - Country:US
Mailing Address - Phone:215-778-5498
Mailing Address - Fax:216-778-8847
Practice Address - Street 1:2500 METROHEALTH DRIVE
Practice Address - Street 2:METROHEALTH SYSTEM / DEPT OF OB/GYN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1998
Practice Address - Country:US
Practice Address - Phone:215-778-5498
Practice Address - Fax:216-778-8847
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-28655207V00000X, 207VM0101X
OH34008903207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26637011OtherBCBS KANSAS CITY
MO245025408Medicaid
673800OtherFIRSTGUARD
KS100359940AMedicaid
160049230OtherRR MEDICARE
OH2691743Medicaid
KS073A389AMedicare ID - Type Unspecified
C42768Medicare UPIN
OH2691743Medicaid