Provider Demographics
NPI:1174600340
Name:MYERSON, ANDREW ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ABRAHAM
Last Name:MYERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1926 CLEARWATER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9191
Mailing Address - Country:US
Mailing Address - Phone:919-960-0350
Mailing Address - Fax:919-929-0365
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:1200D
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-960-0350
Practice Address - Fax:919-929-0365
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC392042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2157476DMedicare ID - Type Unspecified