Provider Demographics
NPI:1598016099
Name:MYERS, ERIC (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:032-967-3208
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:8 RICHLAND MEDICAL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8006
Practice Address - Country:US
Practice Address - Phone:803-434-3800
Practice Address - Fax:803-744-2759
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV76664363LF0000X
SC20163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC89759988OtherMEDICARE
SCNP4090Medicaid
SCSC8975F935OtherMEDICARE
SCNP4090Medicaid