Provider Demographics
NPI:1437127230
Name:MYERS, TINA M (DO)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:KARNOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:484-526-6500
Practice Address - Street 1:2793 GERYVILLE PIKE
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-2306
Practice Address - Country:US
Practice Address - Phone:267-424-8200
Practice Address - Fax:215-541-2987
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010832L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH29376Medicare UPIN
PA044158Medicare ID - Type UnspecifiedMEDICARE