Healthcare Provider Details

I. General information

NPI: 1982650610
Provider Name (Legal Business Name): ALLEN BAILE MYERS,D.O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 CHESTER PIKE
NORWOOD PA
19074-1416
US

IV. Provider business mailing address

515 CHESTER PIKE
NORWOOD PA
19074-1416
US

V. Phone/Fax

Practice location:
  • Phone: 610-532-2244
  • Fax: 610-532-0186
Mailing address:
  • Phone: 610-532-2244
  • Fax: 610-532-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS002213L
License Number StatePA

VIII. Authorized Official

Name: DR. ALLEN BAILE MYERS
Title or Position: PHYSICIAN/PRES.
Credential: D.O.
Phone: 610-532-2244