Provider Demographics
NPI:1740235944
Name:MYERS, GERARD ANTHONY (DO)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:ANTHONY
Last Name:MYERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3627 BRODHEAD RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-2681
Mailing Address - Country:US
Mailing Address - Phone:724-728-7880
Mailing Address - Fax:
Practice Address - Street 1:3627 BRODHEAD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-2681
Practice Address - Country:US
Practice Address - Phone:724-728-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005277208VP0014X
PAOS007907L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000787170OtherBLUE CROSS
PA0014423930007Medicaid
0848831OtherAETNA
990011267OtherPALMETTO GBA
PABM9645384OtherDEA
PA0014423930007Medicaid
990011267OtherPALMETTO GBA
990011267OtherPALMETTO GBA
PAF43939Medicare UPIN