MEDICARE: DR. ROBERT MICHAEL MYERS DMD

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	1223P0221X	Pediatric Dentistry	3863-0644	SC

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	:	1144394305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MICHAEL MYERS DMD

Provider Business Mailing Address
First Line	:	1130 PROFESSIONAL LN
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29466-7193
Country	:	US
Telephone Number	:	843-810-6269
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 MATHIS FERRY RD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-2650
Country	:	US
Telephone Number	:	843-810-6269
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	01/07/2011

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