MEDICARE: DR. GLENN D. MEYERS 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	ME52232	FL
2	207R00000X	Internal Medicine Physician	0101258301	VA
3	207R00000X	Internal Medicine Physician	52457	TN

General Provider Information

NPI Number	:	1639319080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENN D. MEYERS M.D.

Provider Business Mailing Address
First Line	:	333 COMMERCE ST STE 700
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1835
Country	:	US
Telephone Number	:	615-454-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	264A PALM COAST PKWY NE
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8217
Country	:	US
Telephone Number	:	386-446-5505
Fax Number	:

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

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	10/14/2022

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