Provider Demographics
NPI:1659561165
Name:ALEXANDER G.MYERS, M.D., P.C.
Entity Type:Organization
Organization Name:ALEXANDER G.MYERS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-822-5352
Mailing Address - Street 1:72 WASHINGTON ST
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2491
Mailing Address - Country:US
Mailing Address - Phone:508-822-5351
Mailing Address - Fax:508-823-5350
Practice Address - Street 1:72 WASHINGTON ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2491
Practice Address - Country:US
Practice Address - Phone:508-822-5351
Practice Address - Fax:508-823-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37538207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2031825Medicaid
MA2031825Medicaid