Provider Demographics
NPI:1891722005
Name:MYERS, STEVEN L (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:MYERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SPORTSMAN DR
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8572
Mailing Address - Country:US
Mailing Address - Phone:814-226-1070
Mailing Address - Fax:814-226-1072
Practice Address - Street 1:18 SPORTSMAN DR
Practice Address - Street 2:SUITE 20
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8538
Practice Address - Country:US
Practice Address - Phone:814-226-1070
Practice Address - Fax:814-226-1072
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA-000236L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS28585Medicare UPIN
PA882537Medicare ID - Type Unspecified