Provider Demographics
NPI:1750350930
Name:MYERS, THOMAS E (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:MYERS
Suffix:
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:540-349-0100
Mailing Address - Fax:540-349-4401
Practice Address - Street 1:428 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3026
Practice Address - Country:US
Practice Address - Phone:540-349-0100
Practice Address - Fax:540-349-4401
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034906207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006256813Medicaid
211557OtherALLIANCE PPO
286888OtherAMERIGROUP
0004414260OtherAETNA PPO
211557OtherMDIPA OPTIMUM CHOICE
48027OtherCOMMUNITY HEALTH CARE
6256813OtherVIRGINIA PREMIER
6282188OtherCIGNA HEALTH PLANS
211557OtherMAMSI HEALTH PLANS
C3360001OtherCAREFIRST BS
012010OtherANTHEM BS VA
345574OtherNATIONAL CAPITAL PPO
0586575OtherAETNA HMO
VA1750350930Medicaid
0004414260OtherAETNA PPO
6282188OtherCIGNA HEALTH PLANS