Provider Demographics
NPI:1396063582
Name:MEYERS, KARL ROBERT SR (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:ROBERT
Last Name:MEYERS
Suffix:SR
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:PO BOX 2716
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-6716
Mailing Address - Country:US
Mailing Address - Phone:610-667-4384
Mailing Address - Fax:
Practice Address - Street 1:321 CYNWYD RD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2636
Practice Address - Country:US
Practice Address - Phone:610-667-4384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013126E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00966182Medicaid
446949Medicare PIN
PA00966182Medicaid