Provider Demographics
NPI:1407910284
Name:MYERS, WOODROW AUGUSTUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WOODROW
Middle Name:AUGUSTUS
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 N ILLINOIS ST
Mailing Address - Street 2:2101
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1935
Mailing Address - Country:US
Mailing Address - Phone:317-685-9923
Mailing Address - Fax:317-685-9924
Practice Address - Street 1:1 N ILLINOIS ST
Practice Address - Street 2:2101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1935
Practice Address - Country:US
Practice Address - Phone:317-685-9923
Practice Address - Fax:317-685-9924
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG36842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46835Medicare UPIN