Provider Demographics
NPI:1245333558
Name:MYERS, TODD ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALLAN
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3271 RACQUET CLUB DR
Mailing Address - Street 2:VETRANS AFFAIRS CBOC
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4770
Mailing Address - Country:US
Mailing Address - Phone:231-932-9720
Mailing Address - Fax:231-995-9302
Practice Address - Street 1:4343 LANDS END
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-8061
Practice Address - Country:US
Practice Address - Phone:231-922-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301078079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine