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General NPI Number Information
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NPI Number | 1912115619
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Entity Type | Organization
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Legal Business Name | METROPOLITAN NEUROLOGY, LTD
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 10004 KENNERLY RD SUITE 391B
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-843-8222
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Fax |
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Provider Business Mailing Address
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Address Line | 10004 KENNERLY RD SUITE 391B
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-843-8222
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY MYERS
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Credential | MD
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Telephone | 314-843-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | R5513
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License Number State | MO
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