Provider Demographics
NPI:1629078720
Name:MEYERS, GREGORY S (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:S
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 1:1212 GARFIELD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3247
Mailing Address - Country:US
Mailing Address - Phone:304-865-3600
Mailing Address - Fax:304-865-3700
Practice Address - Street 1:407 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1615
Practice Address - Country:US
Practice Address - Phone:740-315-5709
Practice Address - Fax:304-865-3700
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV177972085N0700X, 2085R0202X
OH826272085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0982898OtherMEDICAID
WV0120377000Medicaid
OH0765824Medicare PIN
F85918Medicare UPIN
OH0982898OtherMEDICAID