Provider Demographics
NPI:1437196482
Name:MEYERS, WILLIAM CLARK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLARK
Last Name:MEYERS
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 1:1200 CONSTITUTION AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19112-1323
Mailing Address - Country:US
Mailing Address - Phone:267-592-3200
Mailing Address - Fax:888-393-3980
Practice Address - Street 1:1200 CONSTITUTION AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19112-1329
Practice Address - Country:US
Practice Address - Phone:267-592-3200
Practice Address - Fax:888-393-3980
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150438208600000X
PAMD072993L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery