Provider Demographics
NPI:1639319080
Name:MEYERS, GLENN D (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:D
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 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:615-454-9850
Mailing Address - Fax:
Practice Address - Street 1:264A PALM COAST PKWY NE
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8217
Practice Address - Country:US
Practice Address - Phone:386-446-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52232207R00000X
VA0101258301207R00000X
TN52457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine