MEDICARE: CHRISTINE P POINDEXTER MYATT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K4163	TX
2	207R00000X	Internal Medicine Physician	ME105258	FL
3	208M00000X	Hospitalist Physician	K4163	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134150550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE P POINDEXTER MYATT M.D.

Provider Business Mailing Address
First Line	:	1700 N MCMULLEN BOOTH RD
Second Line	:	STE D-1
City	:	CLEARWATER
State	:	FL
Zip	:	33759-2130
Country	:	US
Telephone Number	:	727-669-3800
Fax Number	:	727-669-5600

Provider Business Practice Location Address
First Line	:	1700 N MCMULLEN BOOTH RD
Second Line	:	STE D-1
City	:	CLEARWATER
State	:	FL
Zip	:	33759-2130
Country	:	US
Telephone Number	:	727-669-3800
Fax Number	:	727-669-5600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/03/2009

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Directions to “ CHRISTINE P POINDEXTER MYATT M.D.” Practice Location

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