Provider Demographics
NPI:1366406365
Name:MYERS, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 EMPIRE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1957
Mailing Address - Country:US
Mailing Address - Phone:585-787-2510
Mailing Address - Fax:585-787-2533
Practice Address - Street 1:2000 EMPIRE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1957
Practice Address - Country:US
Practice Address - Phone:585-922-0930
Practice Address - Fax:585-787-2533
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY137236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI70116Medicare PIN
NYE78500Medicare UPIN
NY01464231Medicare PIN