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NPI Code Detail

MEDICARE: SUSI M MYERS M.D.

MEDICARE: SUSI M MYERS 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
12084P0800XPsychiatry PhysicianMD00039091WA

Other Identifiers

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

General Provider Information

NPI Number : 1255336954
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSI M MYERS M.D.
Provider Business Mailing Address
First Line : 322 W NORTH RIVER DR
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3208
Country : US
Telephone Number : 509-241-2575
Fax Number : 509-241-2312
Provider Business Practice Location Address
First Line : 322 W NORTH RIVER DR
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3208
Country : US
Telephone Number : 509-241-2575
Fax Number : 509-241-2312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 04/27/2021

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