Doctor Name: | DR. DANNY WADELL MYERS |
NPI Number: | 1881671915 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 46840 |
Business Practice Address: | 575 Jefferson Ave Fort Eustis, VA - 236041602 |
Business Phone Number: | 7573147606 |
Business Fax Number: | 7573147726 |
Mailing Address: | 158 Stone Lake Ct, YORKTOWN |
State: | VA |
Postal Code: | 236933714 |
Phone Number: | 7578651127 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | 46840 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |