Provider Demographics
NPI:1750067070
Name:MEYERS, SAMUEL M (PA-C)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:M
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 CONSTITUTION DR STE 217
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6799
Mailing Address - Country:US
Mailing Address - Phone:757-963-7729
Mailing Address - Fax:757-470-5665
Practice Address - Street 1:100 CONSTITUTION DR STE 217
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6799
Practice Address - Country:US
Practice Address - Phone:757-963-7729
Practice Address - Fax:757-470-5665
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant