Provider Demographics
NPI:1518932672
Name:MYERS, PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P O BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:267-370-5296
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:310 FARM LANE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4732
Practice Address - Country:US
Practice Address - Phone:215-348-3990
Practice Address - Fax:215-348-7705
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032809E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119896001OtherKEYSTONE HEALTH PLAN EAST
4708888939OtherFIRST HEALTH CCN
P543145OtherOXFORD
10367500002OtherPA MEDICAL ASSISTANCE
007302OtherAETNA PPO MANAGED CARE
1058233OtherKEYSTONE MERCY HEALTHPLAN
2119896001OtherPERSONAL CHOICE 65
PA0010367500Medicaid
280685OtherMAMSI
PA059248OtherBLUE SHIELD
110243166OtherMEDICARE RAILROAD
470888939OtherHEALTH NET
2119896001OtherAMERIHEALTH ADMINISTRATOR
2119896001OtherKEYSTONE LIAISON
470888939OtherMULTI PLAN
PA0010367500002Medicaid
007302OtherAETNA HMO
4708888939OtherDEVON
470888939OtherINTERCOUNTY
110243166OtherMEDICARE RAILROAD
2119896001OtherKEYSTONE HEALTH PLAN EAST
280685OtherMAMSI